Active NPI
Kiera Lindgren Robertson, ATC
- Athletic Trainer
- Port Jervis, NY
National Provider Identifier
1548578024
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- RT004860
- Practice address
- 520 Old Mountain Rd
Port Jervis, NY 12771-3257 - Phone
- (845) 313-3838
- NPI assigned
- Sep 19, 2010
- Sex
- Female
- 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 | RT004860 | PA | Primary |
Addresses
Primary practice location
520 Old Mountain Rd
Port Jervis, NY 12771-3257
Mailing address
PO Box 344
New Hampton, NY 10958-0344
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 |
|---|---|---|---|
| RT004860 | PA | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1284854400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1284854400000",
"number": "1548578024",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 344",
"city": "NEW HAMPTON",
"state": "NY",
"postal_code": "109580344"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "520 OLD MOUNTAIN RD",
"city": "PORT JERVIS",
"state": "NY",
"postal_code": "127713257",
"telephone_number": "845-313-3838"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTSON",
"first_name": "KIERA",
"middle_name": "LINDGREN",
"credential": "ATC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-09-19",
"last_updated": "2010-09-19",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "PA",
"license": "RT004860",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port Jervis, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.