Active NPI
Katelyn Ellen Dolan
- Athletic Trainer
- Prides Crossing, MA
National Provider Identifier
1780198101
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 2509
- Practice address
- 412 Hale St
Prides Crossing, MA 01965-9800 - Phone
- (978) 236-3010
- NPI assigned
- Nov 21, 2017
- 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 | 3890 | MA | |
| Athletic Trainer | 2255A2300X | 2509 | AL | Primary |
Addresses
Primary practice location
412 Hale St
Prides Crossing, MA 01965-9800
Mailing address
143 Canal St Apt 9
Salem, MA 01970-4603
Phone (845) 803-1181
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 |
|---|---|---|---|
| 2509 | AL | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1511222400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718928000000",
"number": "1780198101",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "143 CANAL ST APT 9",
"city": "SALEM",
"state": "MA",
"postal_code": "019704603",
"telephone_number": "845-803-1181"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "412 HALE ST",
"city": "PRIDES CROSSING",
"state": "MA",
"postal_code": "019659800",
"telephone_number": "978-236-3010"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOLAN",
"first_name": "KATELYN",
"middle_name": "ELLEN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-11-21",
"last_updated": "2024-06-21",
"certification_date": "2024-06-12",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "MA",
"license": "3890",
"primary": false
},
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "AL",
"license": "2509",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Prides Crossing, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.