Emily Kautzman, LAT, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

2366 Issued in TN

Practice address

76 S Houston Levee Rd
Eads, TN 38028-7024

Phone

(901) 765-4600

NPI assigned

Oct 5, 2017

Last updated

Oct 8, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1507161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538956800000",
    "number": "1417467317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "96 RIVER HEIGHTS DR APT 203",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381036976",
            "telephone_number": "406-740-0183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "76 S HOUSTON LEVEE RD",
            "city": "EADS",
            "state": "TN",
            "postal_code": "380287024",
            "telephone_number": "901-765-4600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2300 46th Ave SE Apt 302",
            "address_purpose": "LOCATION",
            "city": "Mandan",
            "state": "ND",
            "postal_code": "585544835",
            "country_code": "US",
            "telephone_number": "406-740-0183",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAUTZMAN",
        "first_name": "EMILY",
        "credential": "LAT, ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-05",
        "last_updated": "2018-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "TN",
            "license": "2366",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Athletic Trainer in Eads, TN
• Providers in Eads, TN by specialty
• Athletic Trainer in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2018; 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.