Karianne Ely, AT, ATC

Key facts

NPI

1497149124

Entity type

Individual (NPI type 1)

Primary specialty

Athletic Trainer 2255A2300X

Practice address

92407 Center Dr
Dowagaic, MI 49047

Phone

(269) 462-5352

NPI assigned

Mar 19, 2015

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

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Dec 9, 2015.

{
    "created_epoch": "1426723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449619200000",
    "number": "1497149124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "92407 CENTER DR",
            "city": "DOWAGIAC",
            "state": "MI",
            "postal_code": "490478850",
            "telephone_number": "269-462-5352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92407 CENTER DR",
            "city": "DOWAGAIC",
            "state": "MI",
            "postal_code": "49047",
            "telephone_number": "269-462-5352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELY",
        "first_name": "KARIANNE",
        "credential": "AT, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-19",
        "last_updated": "2015-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}