Individual provider Active NPI

Kelley A Becker, MED, ATC, LAT

  • Student in an Organized Health Care Education/Training Program
  • Akron, OH
National Provider Identifier
1578770814
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
AT001807 Issued in OH
Practice address
The University of Akron
Athletics Fieldhouse, Suite 184D
Akron, OH 44325-6302
Phone
(330) 972-5528
Fax
(330) 972-5253
NPI assigned
May 17, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X AT001807 OH Primary

Addresses

Primary practice location

The University of Akron
Athletics Fieldhouse, Suite 184D
Akron, OH 44325-6302

Mailing address

123 Washington Ave
Cuyahoga Falls, OH 44221-2321
Phone (330) 940-3544

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 Education

State licenses

LicenseStateTypeSpecialty
AT001807OHMDStudent in an Organized Health Care Education/Training Program

NPI Registry JSON

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1578770814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 WASHINGTON AVE",
            "city": "CUYAHOGA FALLS",
            "state": "OH",
            "postal_code": "442212321",
            "telephone_number": "330-940-3544",
            "fax_number": "330-972-5253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "THE UNIVERSITY OF AKRON",
            "address_2": "ATHLETICS FIELDHOUSE, SUITE 184D",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443256302",
            "telephone_number": "330-972-5528",
            "fax_number": "330-972-5253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BECKER",
        "first_name": "KELLEY",
        "middle_name": "A",
        "credential": "MED, ATC, LAT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OH",
            "license": "AT001807",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Akron, OH

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.

Verify at the official NPI Registry.