Katie Lynn Fails, PT, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

2012011128 Issued in MO

Practice address

4331 S Fremont Ave
Springfield, MO 65804-7328

Phone

(417) 820-5010

NPI assigned

Aug 3, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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": "1343952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343952000000",
    "number": "1598011900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4331 S FREMONT AVE",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658047328",
            "telephone_number": "417-820-5010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4331 S FREMONT AVE",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658047328",
            "telephone_number": "417-820-5010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAILS",
        "first_name": "KATIE",
        "middle_name": "LYNN",
        "credential": "PT, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-03",
        "last_updated": "2012-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2012023500",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MO",
            "license": "2012011128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Quintin E Ewing, MSW, LCSW
• Exercise and Rehab Equipment
• Eye Surgeons of Springfield, Inc.
• Eyemart Express LLC
• Eyemart Express, LTD.
• Amber Fain-Leslie, PH.D.
• Thomas A Fairbairn, CRNA
• Tracy D. Fairbairn, CRNA
• Brent R Fairbanks, AA
• Jane M Fairchild, MA, LPC

• Athletic Trainer in Springfield, MO
• Providers in Springfield, MO by specialty
• Athletic Trainer in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2012; 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.