Active NPI
Kennady T Oliver
- Student in an Organized Health Care Education/Training Program
- West Lafayette, IN
National Provider Identifier
1740894385
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 900 N John R Wooden Dr
West Lafayette, IN 47907-2117 - Phone
- (765) 494-3325
- NPI assigned
- Sep 1, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | IN | ||
| Student in an Organized Health Care Education/Training Program | 390200000X | IN | Primary |
Addresses
Primary practice location
900 N John R Wooden Dr
West Lafayette, IN 47907-2117
Mailing address
900 N John R Wooden Dr
West Lafayette, IN 47907-2117
Phone (765) 494-3325
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | oliver66@purdue.edu | Direct |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1598918400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1598918400000",
"number": "1740894385",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "900 N JOHN R WOODEN DR",
"city": "WEST LAFAYETTE",
"state": "IN",
"postal_code": "479072117",
"telephone_number": "765-494-3325"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "900 N JOHN R WOODEN DR",
"city": "WEST LAFAYETTE",
"state": "IN",
"postal_code": "479072117",
"telephone_number": "765-494-3325"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLIVER",
"first_name": "KENNADY",
"middle_name": "T",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-09-01",
"last_updated": "2020-09-01",
"certification_date": "2020-09-01",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "IN",
"license": null,
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "IN",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "oliver66@purdue.edu",
"affiliation": "N",
"endpointDescription": "Email",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "2731 Speedwell Ln",
"city": "Lafayette",
"state": "IN",
"country_code": "US",
"postal_code": "479098378",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in West Lafayette, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.