Individual provider Active NPI

Kyle Michael Rentschler, LAT, ATC, MS

  • Athletic Trainer
  • Port Orange, FL
National Provider Identifier
1417518994
Registry record updated Jun 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
AL-2683 Issued in FL
Practice address
801 Taylor Rd
Port Orange, FL 32127-4715
Phone
(386) 322-6272
NPI assigned
Jun 25, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 25, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X AL-2683 FL Primary

Addresses

Primary practice location

801 Taylor Rd
Port Orange, FL 32127-4715

Mailing address

157 Integra Breeze LN Unit 101
Daytona Beach, FL 32117-5586
Phone (610) 413-1081

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
AL-2683FLMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1561420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561420800000",
    "number": "1417518994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "157 INTEGRA BREEZE LN UNIT 101",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321175586",
            "telephone_number": "610-413-1081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 TAYLOR RD",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321274715",
            "telephone_number": "386-322-6272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENTSCHLER",
        "first_name": "KYLE",
        "middle_name": "MICHAEL",
        "credential": "LAT, ATC, MS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-06-25",
        "last_updated": "2019-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "FL",
            "license": "AL-2683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Orange, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 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.