Active NPI
Katherine Harris, MS, ATC
- Athletic Trainer
- Broomfield, CO
National Provider Identifier
1669049417
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 0002002
- Practice address
- 11837 Ridge Pkwy Apt 428
Broomfield, CO 80021-5093 - Phone
- (949) 292-8418
- NPI assigned
- Jun 9, 2021
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 0002002 | CO | Primary |
Addresses
Primary practice location
11837 Ridge Pkwy Apt 428
Broomfield, CO 80021-5093
Mailing address
11837 Ridge Pkwy Apt 428
Broomfield, CO 80021-5093
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 22 | Other | RESPIRATORY, REHABILITATIVE, AND RESTORATIVE SERVICES |
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 |
|---|---|---|---|
| 0002002 | CO | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1623196800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623196800000",
"number": "1669049417",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11837 RIDGE PKWY APT 428",
"city": "BROOMFIELD",
"state": "CO",
"postal_code": "800215093"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11837 RIDGE PKWY APT 428",
"city": "BROOMFIELD",
"state": "CO",
"postal_code": "800215093",
"telephone_number": "949-292-8418"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRIS",
"first_name": "KATHERINE",
"credential": "MS, ATC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-06-09",
"last_updated": "2021-06-09",
"certification_date": "2021-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "CO",
"license": "0002002",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RESPIRATORY, REHABILITATIVE, AND RESTORATIVE SERVICES",
"identifier": "22",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Broomfield, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.