Active NPI
Kelsey Schenewerk, ATC, LAT
- Athletic Trainer
- Jefferson City, MO
National Provider Identifier
1609334416
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 2021023493
- Practice address
- 400 Schellridge Rd
Jefferson City, MO 65109-1191 - Phone
- (573) 301-9012
- NPI assigned
- Mar 11, 2019
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Athletic Trainer | 2255A2300X | 2021023493 | MO | Primary |
Addresses
Primary practice location
400 Schellridge Rd
Jefferson City, MO 65109-1191
Mailing address
400 Schellridge Rd
Jefferson City, MO 65109-1191
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 |
|---|---|---|---|
| 2021023493 | MO | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1552262400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1672963200000",
"number": "1609334416",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 SCHELLRIDGE RD",
"city": "JEFFERSON CITY",
"state": "MO",
"postal_code": "651091191"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 SCHELLRIDGE RD",
"city": "JEFFERSON CITY",
"state": "MO",
"postal_code": "651091191",
"telephone_number": "573-301-9012"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCHENEWERK",
"first_name": "KELSEY",
"credential": "ATC, LAT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-03-11",
"last_updated": "2023-01-06",
"certification_date": "2023-01-06",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "2255A2300X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "MO",
"license": "2021023493",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jefferson City, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.