Individual provider Active NPI

Kimberly Zoller, ATC, LAT

  • Athletic Trainer
  • San Antonio, TX
National Provider Identifier
1750756177
Registry record updated Dec 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
AT5335 Issued in TX
Practice address
4301 Broadway Cpo #288
San Antonio, TX 78209
Phone
(210) 829-3826
NPI assigned
Dec 10, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X AT5335 TX Primary

Addresses

Primary practice location

4301 Broadway Cpo #288
San Antonio, TX 78209

Mailing address

14811 Huebner Rd
Apt 1207
San Antonio, TX 78231-1741
Phone (432) 638-0366

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

LicenseStateTypeSpecialty
AT5335TXMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
University of the Incarnate Word Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1449705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449705600000",
    "number": "1750756177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14811 HUEBNER RD",
            "address_2": "APT 1207",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782311741",
            "telephone_number": "432-638-0366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 BROADWAY CPO #288",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78209",
            "telephone_number": "210-829-3826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZOLLER",
        "first_name": "KIMBERLY",
        "credential": "ATC, LAT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-10",
        "last_updated": "2015-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "TX",
            "license": "AT5335",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2015; 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.