Active NPI
Kalilah Kemp, ATC
- Athletic Trainer
- Clarksdale, MS
National Provider Identifier
1679985493
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AT0611
- Practice address
- 785 Ohio Ave
Suite 1H
Clarksdale, MS 38614-6217 - Phone
- (662) 621-2438
- Fax
- (662) 624-4081
- NPI assigned
- May 28, 2014
- 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 | AT0611 | MS | Primary |
Addresses
Primary practice location
785 Ohio Ave
Suite 1H
Clarksdale, MS 38614-6217
Mailing address
426 Coahoma Ave
Clarksdale, MS 38614-5330
Phone (662) 645-1913
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 |
|---|---|---|---|
| AT0611 | MS | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1401235200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1401235200000",
"number": "1679985493",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "426 COAHOMA AVE",
"city": "CLARKSDALE",
"state": "MS",
"postal_code": "386145330",
"telephone_number": "662-645-1913"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "785 OHIO AVE",
"address_2": "SUITE 1H",
"city": "CLARKSDALE",
"state": "MS",
"postal_code": "386146217",
"telephone_number": "662-621-2438",
"fax_number": "662-624-4081"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KEMP",
"first_name": "KALILAH",
"credential": "ATC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-05-28",
"last_updated": "2014-05-28",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "MS",
"license": "AT0611",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clarksdale, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.