Kelly Michele Krivulka, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

Practice address

5850 E Still Cir
Mesa, AZ 85206-3618

Phone

(480) 219-6000

NPI assigned

Feb 26, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1519603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556668800000",
    "number": "1720589609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "544 DAIRY WAY",
            "city": "BUELLTON",
            "state": "CA",
            "postal_code": "934279302",
            "telephone_number": "805-245-5419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5850 E STILL CIR",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852063618",
            "telephone_number": "480-219-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2000 Park Ave Apt 14",
            "address_purpose": "LOCATION",
            "city": "Long Beach",
            "state": "CA",
            "postal_code": "908152876",
            "country_code": "US",
            "telephone_number": "805-245-5419",
            "fax_number": "805-245-5419",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KRIVULKA",
        "first_name": "KELLY",
        "middle_name": "MICHELE",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-02-26",
        "last_updated": "2019-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATIONAL ATHLETIC TRAINERS' ASSOCIATION",
            "identifier": "93650",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOC",
            "identifier": "2000034465",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kris Eldridge, LPC
• Amy Nicole Kriser
• Prashant Vasanth Krishnan, M.D.
• Lara Catherine Kristof, MA, CCC-SLP
• Brook A Kritzstein, LCSW
• Christina Isabele Krize, CPM, LM
• Brenda Kronborg, D.O.
• Daniel Jayson Kronemeyer
• Adam M. Kruczay, DPM
• Teri Virginia Krull, LCSW

• Athletic Trainer in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Athletic Trainer in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2019; 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.