Active NPI
Danetta Hicks Kemp, MS, ATC
- Athletic Trainer
- Decatur, GA
National Provider Identifier
1578760559
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AT000620
- Practice address
- 5040 Snapfinger Woods Dr
Suite 205
Decatur, GA 30035-4020 - Phone
- (678) 205-5736
- NPI assigned
- Jul 2, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | AT000620 | GA | Primary |
Addresses
Primary practice location
5040 Snapfinger Woods Dr
Suite 205
Decatur, GA 30035-4020
Mailing address
2610 Casher Dr
Decatur, GA 30034-1009
Phone (404) 343-0106
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AT000620 | GA | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1183334400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1578760559",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2610 CASHER DR",
"city": "DECATUR",
"state": "GA",
"postal_code": "300341009",
"telephone_number": "404-343-0106"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5040 SNAPFINGER WOODS DR",
"address_2": "SUITE 205",
"city": "DECATUR",
"state": "GA",
"postal_code": "300354020",
"telephone_number": "678-205-5736"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KEMP",
"first_name": "DANETTA",
"middle_name": "HICKS",
"name_prefix": "Ms.",
"credential": "MS, ATC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-07-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "GA",
"license": "AT000620",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Decatur, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.