Muharem Komic, MAT, PES

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

Practice address

210 Lindsey Wilson St
Columbia, KY 42728-1223

Phone

(800) 264-0138

NPI assigned

Jul 10, 2023

Last updated

Jul 10, 2023By the provider in NPPES

Sex

Male

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

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

{
    "created_epoch": "1688947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688947200000",
    "number": "1720766629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "419 W RIPA AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631252740",
            "telephone_number": "314-680-9031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 LINDSEY WILSON ST",
            "city": "COLUMBIA",
            "state": "KY",
            "postal_code": "427281223",
            "telephone_number": "800-264-0138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOMIC",
        "first_name": "MUHAREM",
        "credential": "MAT, PES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-10",
        "last_updated": "2023-07-10",
        "certification_date": "2023-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yuichi Kitagawa, PA-C
• Clinton Shain Kiteck, D.O.
• Jerry William Knifley, RPH.
• Ashley B Knopp, APRN
• Kiyomasa Komatsu, MS, ATC
• Jessica Lacy
• Lake Cumberland District Health Department (Adair County Health Department)
• Lake Cumberland District Health Department (Adair County Primary Center)
• Lake Cumberland District Health Dept (Col. William Casey Elem. School)
• Lake Cumberland District Health Dept (Adair Co. Middle School)

• Athletic Trainer in Columbia, KY
• Providers in Columbia, KY by specialty
• Athletic Trainer in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2023; 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.