Active NPI
Tim Newell Jr., LAT, ATC
- Athletic Trainer
- Crestview Hills, KY
National Provider Identifier
1508142647
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AT1212
- Practice address
- 333 Thomas More Pkwy
Crestview Hills, KY 41017-3428 - Phone
- (859) 344-3635
- NPI assigned
- Nov 2, 2011
- Sex
- Male
- 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 | AT1212 | KY | Primary |
| Athletic Trainer | 2255A2300X | AT.004552 | OH |
Addresses
Primary practice location
333 Thomas More Pkwy
Crestview Hills, KY 41017-3428
Mailing address
333 Thomas More Pkwy
Crestview Hills, KY 41017-3428
Phone (859) 344-3635
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 |
|---|---|---|---|
| AT1212 | KY | MD | Athletic Trainer |
| AT.004552 | OH | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1320192000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1433721600000",
"number": "1508142647",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "333 THOMAS MORE PKWY",
"city": "CRESTVIEW HILLS",
"state": "KY",
"postal_code": "410173428",
"telephone_number": "859-344-3635"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "333 THOMAS MORE PKWY",
"city": "CRESTVIEW HILLS",
"state": "KY",
"postal_code": "410173428",
"telephone_number": "859-344-3635"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NEWELL",
"first_name": "TIM",
"name_suffix": "Jr.",
"credential": "LAT, ATC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-11-02",
"last_updated": "2015-06-08",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "KY",
"license": "AT1212",
"primary": true
},
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "OH",
"license": "AT.004552",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Crestview Hills, KY
- Scott Andrew Neltner, M.D.
- Neuroscience and Behavioral Health Associates
- Neuroscience Associates of Northern Kentucky PSC
- Neuroscience Associates of Northern Kentucky,PSC
- David Andrew Neville, DC
- Tann A Nichols, MD
- Aaron Robert Noll, M.D.
- Jean M Noll, M.D.
- Sharon Lynn Noll, PT
- Northern Kentucky Arthritis Rheumatology and Infusion LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 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.