Active NPI
Gabrielle Debolt
- Athletic Trainer
- Fort Campbell, KY
National Provider Identifier
1619696267
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AT10135
- Practice address
- 2270 Kentucky Ave
Fort Campbell, KY 42223-5362 - Phone
- (270) 798-4023
- NPI assigned
- Aug 25, 2022
- 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 | AT10135 | TX | Primary |
Addresses
Primary practice location
2270 Kentucky Ave
Fort Campbell, KY 42223-5362
Mailing address
2270 Kentucky Ave
Fort Campbell, KY 42223-5362
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 |
|---|---|---|---|
| AT10135 | TX | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1661385600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1761696000000",
"number": "1619696267",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2270 KENTUCKY AVE",
"city": "FORT CAMPBELL",
"state": "KY",
"postal_code": "422235362"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2270 KENTUCKY AVE",
"city": "FORT CAMPBELL",
"state": "KY",
"postal_code": "422235362",
"telephone_number": "270-798-4023"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEBOLT",
"first_name": "GABRIELLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-08-25",
"last_updated": "2025-10-29",
"certification_date": "2025-10-29",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "TX",
"license": "AT10135",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Campbell, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.