Active NPI
Rachael Bousman, CAT, MED
- Athletic Trainer
- Kailua, HI
National Provider Identifier
1699307744
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AT-415
- Practice address
- Building 4077 Harris Ave
Marine Corps Base Hawaii
Kailua, HI 96734 - Phone
- (808) 496-3966
- NPI assigned
- Feb 6, 2020
- 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 | AT-415 | HI | Primary |
Addresses
Primary practice location
Building 4077 Harris Ave
Marine Corps Base Hawaii
Kailua, HI 96734
Mailing address
5030 Waikulu Dr
Kailua, HI 96734-4953
Phone (513) 582-2972
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 Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AT-415 | HI | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1580947200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1714348800000",
"number": "1699307744",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5030 WAIKULU DR",
"city": "KAILUA",
"state": "HI",
"postal_code": "967344953",
"telephone_number": "513-582-2972"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "BUILDING 4077 HARRIS AVE",
"address_2": "MARINE CORPS BASE HAWAII",
"city": "KAILUA",
"state": "HI",
"postal_code": "96734",
"telephone_number": "808-496-3966"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOUSMAN",
"first_name": "RACHAEL",
"credential": "CAT, MED",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-02-06",
"last_updated": "2024-04-29",
"certification_date": "2024-04-29",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "HI",
"license": "AT-415",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kailua, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.