Emily Kathleen Weber, AT, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

2601001708 Issued in MI

Practice address

4177 Village Park Dr Ste B
Traverse City, MI 49685-7237

Phone

(231) 421-5805

Fax

(231) 421-5308

NPI assigned

Dec 5, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Elite Physical Therapy and Sports Performance

  • Physical Therapy Clinic/Center
  • Traverse City, MI
  • NPI 1427343383
  NPD

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

{
    "created_epoch": "1670198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670198400000",
    "number": "1679283238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4177 VILLAGE PARK DR STE B",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496857237",
            "telephone_number": "231-421-5805",
            "fax_number": "231-421-5308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4177 VILLAGE PARK DR STE B",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496857237",
            "telephone_number": "231-421-5805",
            "fax_number": "231-421-5308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEBER",
        "first_name": "EMILY",
        "middle_name": "KATHLEEN",
        "credential": "AT, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-05",
        "last_updated": "2022-12-05",
        "certification_date": "2022-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MI",
            "license": "2601001708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles W Webb, MD
• Cindy Webb, L.M.T
• Erin Webb, LMSW, MPH
• Madison Marie Webb
• Abbie Lynn Marie Weber
• Gabrielle Weber
• Jeffrey Scott Weber, D.P.M.
• Jillian Weber
• Kevin P Weber, M.D.
• Sydney R Weber

• Athletic Trainer in Traverse City, MI
• Providers in Traverse City, MI by specialty
• Athletic Trainer in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2022; 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.