Merrisa Kennedy Heraldson, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

TCA572 Issued in KY

Practice address

400 E College St
Georgetown, KY 40324-1628

Phone

(859) 806-6187

NPI assigned

Aug 2, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

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": "1501632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1501632000000",
    "number": "1457875205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 CAROLINE PATH APT 5",
            "city": "GEORGETOWN",
            "state": "KY",
            "postal_code": "403240528",
            "telephone_number": "502-609-7625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E COLLEGE ST",
            "city": "GEORGETOWN",
            "state": "KY",
            "postal_code": "403241628",
            "telephone_number": "859-806-6187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERALDSON",
        "first_name": "MERRISA",
        "middle_name": "KENNEDY",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-02",
        "last_updated": "2017-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "KY",
            "license": "TCA572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jayden Henderson, LMT
• Robert W Henderson, DMD
• Brian Keith Hendrix, D.C.
• Taylor Henry, APRN
• Katherine Marie Henson, MA, CCC-SLP
• Jana Hess, PHARMD
• Shirley Beth Hicks
• Trisha Hieronymus
• Abigail Higgins, PHARMD
• Melyssa Hill

• Athletic Trainer in Georgetown, KY
• Providers in Georgetown, KY by specialty
• Athletic Trainer in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2017; 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.