Active NPI
Kindee Lynn Wilson, MSAT, LAT, ATC
- Athletic Trainer
- Filer, ID
National Provider Identifier
1750832994
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AT-595
- Practice address
- 3804 N 1900 E
Filer, ID 83328-5242 - Phone
- (208) 731-5480
- NPI assigned
- Oct 24, 2016
- 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-595 | ID | Primary |
Addresses
Primary practice location
3804 N 1900 E
Filer, ID 83328-5242
Mailing address
3804 N 1900 E
Filer, ID 83328
Phone (208) 731-5480
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2000025663 | Other | ID | BOC |
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
| License | State | Type | Specialty |
|---|---|---|---|
| AT-595 | ID | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1477267200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1477267200000",
"number": "1750832994",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3804 N 1900 E",
"city": "FILER",
"state": "ID",
"postal_code": "83328",
"telephone_number": "208-731-5480"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3804 N 1900 E",
"city": "FILER",
"state": "ID",
"postal_code": "833285242",
"telephone_number": "208-731-5480"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "KINDEE",
"middle_name": "LYNN",
"credential": "MSAT, LAT, ATC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-10-24",
"last_updated": "2016-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "ID",
"license": "AT-595",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BOC",
"identifier": "2000025663",
"state": "ID"
}
],
"endpoints": [],
"other_names": []
}Other providers in Filer, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.