Kathleen Mayree Shadish, LAT, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

0126002868 Issued in VA

Practice address

3 Bishop Aly
Cecil, PA 15321

Phone

(412) 913-1812

NPI assigned

Feb 7, 2017

Last updated

Jun 12, 2018By the provider in NPPES

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": "1486425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528761600000",
    "number": "1477091759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 BISHOP ALY",
            "city": "CECIL",
            "state": "PA",
            "postal_code": "153211199",
            "telephone_number": "412-913-1812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 BISHOP ALY",
            "city": "CECIL",
            "state": "PA",
            "postal_code": "15321",
            "telephone_number": "412-913-1812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHADISH",
        "first_name": "KATHLEEN",
        "middle_name": "MAYREE",
        "credential": "LAT, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-07",
        "last_updated": "2018-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "VA",
            "license": "0126002868",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Desafey II, RN
• Sarah Carolyn Duncan, MD
• Donald J Faith, MD
• Jennifer Ilconich, MA, CCC-SLP
• George E Khoury, D.C.
• Mylaina Lyn Sherwood, M.D.
• Steel City Chiropractic, LLC
• The Washington Physician Hospital Organization, Inc.
• Washington Physician Services Organization (Washington Health System Cardiovascular Care - Cecil)
• Washington Physician Services Organization (Washington Health System Foot and Ankle Specialists)

• Athletic Trainer in Cecil, PA
• Providers in Cecil, PA by specialty
• Athletic Trainer in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2018; 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.