Active NPI
Kimberly Lynn Noon, ATC L
- Athletic Trainer
- Plymouth, IN
National Provider Identifier
1760455448
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 36000934A
- Practice address
- 1915 Lake Ave
Plymouth, IN 46563-9366 - Phone
- (574) 936-3181
- NPI assigned
- Feb 11, 2006
- Last updated
- Jul 8, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 36000934A | IN | Primary |
Addresses
Primary practice location
1915 Lake Ave
Plymouth, IN 46563-9366
Mailing address
17692 Lincoln Hwy
Plymouth, IN 46563-8857
Phone (765) 427-2399
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 |
|---|---|---|---|
| 36000934A | IN | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139616000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1760455448",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17692 LINCOLN HWY",
"city": "PLYMOUTH",
"state": "IN",
"postal_code": "465638857",
"telephone_number": "765-427-2399"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1915 LAKE AVE",
"city": "PLYMOUTH",
"state": "IN",
"postal_code": "465639366",
"telephone_number": "574-936-3181"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NOON",
"first_name": "KIMBERLY",
"middle_name": "LYNN",
"credential": "ATC L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-02-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "IN",
"license": "36000934A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Plymouth, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.