Kimberly Plaza, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AT8610 Issued in TX

Practice address

500 E College St
Marshall, MO 65340-3109

Phone

(660) 831-4195

NPI assigned

Oct 22, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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": "1508630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691625600000",
    "number": "1457862005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1032 WINNSBORO LOOP",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786643312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 E COLLEGE ST",
            "city": "MARSHALL",
            "state": "MO",
            "postal_code": "653403109",
            "telephone_number": "660-831-4195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLAZA",
        "first_name": "KIMBERLY",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-22",
        "last_updated": "2023-08-10",
        "certification_date": "2023-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MO",
            "license": "2017035329",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "TX",
            "license": "AT8610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lindsey Parton
• Carrie M Peecher, DO
• Rebecca Pence, FNP, MSN, ADN
• Megan Petty
• Glenda E Pittman, MSW, LCSW
• Angela Louise Pogue
• Jeana Pointer, MPT
• Pro Touch Investments, Inc.
• Timothy B Raleigh, DO
• Wallace Eugene Ralston, CRNA

• All providers in Marshall, MO
• Athletic Trainer in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2023; 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.