Active NPI
Keeley Glonek
- Athletic Trainer
- Maumee, OH
National Provider Identifier
1487039467
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- L450589
- Practice address
- 2838 Byrnwyck W
Maumee, OH 43537-9724 - Phone
- (419) 779-7654
- NPI assigned
- Jul 20, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | L450589 | MI | Primary |
| Athletic Trainer | 2255A2300X | AT.004399 | OH |
Addresses
Primary practice location
2838 Byrnwyck W
Maumee, OH 43537-9724
Mailing address
2838 Byrnwyck W
Maumee, OH 43537-9724
Phone (419) 779-7654
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| L450589 | MI | MD | Athletic Trainer |
| AT.004399 | OH | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1437350400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1437350400000",
"number": "1487039467",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2838 BYRNWYCK W",
"city": "MAUMEE",
"state": "OH",
"postal_code": "435379724",
"telephone_number": "419-779-7654"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2838 BYRNWYCK W",
"city": "MAUMEE",
"state": "OH",
"postal_code": "435379724",
"telephone_number": "419-779-7654"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GLONEK",
"first_name": "KEELEY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-07-20",
"last_updated": "2015-07-20",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "MI",
"license": "L450589",
"primary": true
},
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "OH",
"license": "AT.004399",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Maumee, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 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.