Active NPI
Kathryn Andersen, LAT, ATC, NREMT
- Athletic Trainer
- Parkville, MD
National Provider Identifier
1508324070
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- A0000962
- Practice address
- 9512 Harford Rd
Parkville, MD 21234-3100 - Phone
- (410) 882-3010
- NPI assigned
- Mar 4, 2019
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Basic Emergency Medical Technician | 146N00000X | 1852246 | MD | |
| Athletic Trainer | 2255A2300X | A0000962 | MD | Primary |
Addresses
Primary practice location
9512 Harford Rd
Parkville, MD 21234-3100
Mailing address
17400 Bushland Rd
Parkton, MD 21120-9478
Phone (443) 966-0349
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 |
|---|---|---|---|
| 1852246 | MD | MD | Basic Emergency Medical Technician |
| A0000962 | MD | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1551657600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1551657600000",
"number": "1508324070",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17400 BUSHLAND RD",
"city": "PARKTON",
"state": "MD",
"postal_code": "211209478",
"telephone_number": "443-966-0349"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9512 HARFORD RD",
"city": "PARKVILLE",
"state": "MD",
"postal_code": "212343100",
"telephone_number": "410-882-3010"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSEN",
"first_name": "KATHRYN",
"credential": "LAT, ATC, NREMT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-03-04",
"last_updated": "2019-03-04",
"status": "A"
},
"taxonomies": [
{
"code": "146N00000X",
"taxonomy_group": "",
"desc": "Emergency Medical Technician, Basic",
"state": "MD",
"license": "1852246",
"primary": false
},
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "MD",
"license": "A0000962",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Parkville, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.