Kendra Weber, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

36000549A Issued in IN

Practice address

904 Woodbine Way
South Bend, IN 46628-1241

Phone

(574) 289-2884

NPI assigned

Apr 21, 2014

Last updated

Apr 21, 2014By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1398038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398038400000",
    "number": "1518387216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "904 WOODBINE WAY",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466281241",
            "telephone_number": "574-289-2884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 WOODBINE WAY",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466281241",
            "telephone_number": "574-289-2884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEBER",
        "first_name": "KENDRA",
        "name_prefix": "Mrs.",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-21",
        "last_updated": "2014-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IN",
            "license": "36000549A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Travis Weaver, D.O.
• Alesha Webb
• Patrick Marvin Webb, M.D.
• Marlise Ann Webber, NP
• Daniel Joseph Weber, M.D.
• Natalie Fay Webster, DO
• Shiloh Wedermyer, PHARM.D.
• Briana R Weidler-Edholm, NP
• Samantha Rae Weidner, DPT
• Harvey Weingarten, DDS

• Athletic Trainer in South Bend, IN
• Providers in South Bend, IN by specialty
• Athletic Trainer in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.