Kathleen Mayree Shadish, LAT, ATC
Individual provider Active NPI Athletic Trainer · Cecil, PA
NPI 1477091759 · NPPES record last updated Jun 12, 2018
Key facts
- NPI
- 1477091759
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- License
- 0126002868 (VA)
- Practice address
- 3 Bishop Aly
Cecil, PA 15321 - Phone
- (412) 913-1812
- NPI assigned
- Feb 7, 2017
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0126002868 | VA | MD | Athletic Trainer |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Athletic Trainer | 2255A2300X | 0126002868 | VA | Yes |
Addresses
Primary practice location
3 Bishop Aly
Cecil, PA 15321
Mailing address
3 Bishop Aly
Cecil, PA 15321-1199
Phone (412) 913-1812
Other providers in Cecil, PA
- David Desafey II
- Sarah Carolyn Duncan
- Donald J Faith
- Jennifer Ilconich
- George E Khoury
- Mylaina Lyn Sherwood
- Steel City Chiropractic, LLC
- The Washington Physician Hospital Organization, Inc.
- Washington Physician Services Organization
- Washington Physician Services Organization
All providers in Cecil, PA · Athletic Trainer in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 12, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.