Active NPI
Kyle Dalton Flora, LAT, ATC
- Athletic Trainer
- Youngstown, OH
National Provider Identifier
1508484189
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AT006177
- Practice address
- 577 5TH Ave RM 1103
Youngstown, OH 44502 - Phone
- (330) 941-3190
- NPI assigned
- Jul 9, 2020
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | AT006177 | OH | Primary |
Addresses
Primary practice location
577 5TH Ave RM 1103
Youngstown, OH 44502
Mailing address
4841 Westchester Dr Apt 320
Austintown, OH 44515-2555
Phone (206) 794-3778
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 |
|---|---|---|---|
| AT006177 | OH | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1594252800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1594252800000",
"number": "1508484189",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4841 WESTCHESTER DR APT 320",
"city": "AUSTINTOWN",
"state": "OH",
"postal_code": "445152555",
"telephone_number": "206-794-3778"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "577 5TH AVE RM 1103",
"city": "YOUNGSTOWN",
"state": "OH",
"postal_code": "44502",
"telephone_number": "330-941-3190"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FLORA",
"first_name": "KYLE",
"middle_name": "DALTON",
"credential": "LAT, ATC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-07-09",
"last_updated": "2020-07-09",
"certification_date": "2020-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "OH",
"license": "AT006177",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Youngstown, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.