Kacey Hildebrand, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AT001253 Issued in WV

Practice address

2828 1St Ave Ste 400
Huntington, WV 25702-1236

Phone

(304) 525-2690

Fax

(304) 529-6880

NPI assigned

Oct 4, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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": "1443916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443916800000",
    "number": "1467822338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2828 1ST AVE STE 400",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257021236",
            "telephone_number": "304-525-2690",
            "fax_number": "304-529-6880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2828 1ST AVE STE 400",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257021236",
            "telephone_number": "304-525-2690",
            "fax_number": "304-529-6880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HILDEBRAND",
        "first_name": "KACEY",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-04",
        "last_updated": "2015-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "WV",
            "license": "AT001253",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0010681000",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "352265",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Athletic Trainer in Huntington, WV
• Providers in Huntington, WV by specialty
• Athletic Trainer in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2015; 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.