Kristina Marie Medinger, DAT

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

2346 Issued in NC

Practice address

4290 Tabernacle Rd
Lancaster, SC 29720

Phone

(803) 286-7068

NPI assigned

Jan 18, 2019

Sex

Female

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 29, 2019.

{
    "created_epoch": "1547769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559088000000",
    "number": "1407320815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 RUFTY CIR",
            "city": "SALISBURY",
            "state": "NC",
            "postal_code": "281449488",
            "telephone_number": "609-352-1938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4290 TABERNACLE RD",
            "city": "LANCASTER",
            "state": "SC",
            "postal_code": "29720",
            "telephone_number": "803-286-7068"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7650 Griffins Gate Dr SW",
            "address_purpose": "LOCATION",
            "city": "Concord",
            "state": "NC",
            "postal_code": "280251628",
            "country_code": "US",
            "telephone_number": "704-260-6410",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEDINGER",
        "first_name": "KRISTINA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "DAT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-18",
        "last_updated": "2019-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NC",
            "license": "2346",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.