Kosie L Shepherd-Porada, MS, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

RT003694 Issued in PA

Practice address

927 Menoher Blvd
Johnstown, PA 15905-2834

Phone

(814) 255-6814

Fax

(814) 255-7963

NPI assigned

Apr 7, 2009

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Western Pennsylvania Sports Medicine & Rehabilitation Center, Inc.

  • Physical Therapy Clinic/Center
  • Johnstown, PA
  • NPI 1427123660
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1239062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1239062400000",
    "number": "1477796456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "927 MENOHER BLVD",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159052834",
            "telephone_number": "814-255-6814",
            "fax_number": "814-255-7963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "927 MENOHER BLVD",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159052834",
            "telephone_number": "814-255-6814",
            "fax_number": "814-255-7963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPHERD-PORADA",
        "first_name": "KOSIE",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "MS, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-07",
        "last_updated": "2009-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "PA",
            "license": "RT003694",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kamran Shayesteh, D.O.
• Charles Gordon Shea, DMD
• Annette Shearman, MSCCCSLP
• William Sheffler
• Shellby Custer LSW, P.C.
• Navi Shergill, MD
• David Sheridan
• Matthew R Sheridan, O.D.
• Megan S Sheridan
• Sarah Elizabeth Sherry, LSW

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2009; 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.