Active NPI
Kathleen Matie Donica, A.T.,C.
- Athletic Trainer
- Tulsa, OK
National Provider Identifier
1780858332
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AT100
- Practice address
- 6048 S Sheridan Rd
Tulsa, OK 74145-9212 - Phone
- (918) 591-3897
- NPI assigned
- Apr 15, 2008
- 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 | AT100 | OK | Primary |
Addresses
Primary practice location
6048 S Sheridan Rd
Tulsa, OK 74145-9212
Mailing address
9815 S. 239TH E. Ave
Brokne Arrow, OK 74014
Phone (918) 637-3717
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 |
|---|---|---|---|
| AT100 | OK | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1208217600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1208217600000",
"number": "1780858332",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9815 S. 239TH E. AVE",
"city": "BROKNE ARROW",
"state": "OK",
"postal_code": "74014",
"telephone_number": "918-637-3717"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6048 S SHERIDAN RD",
"city": "TULSA",
"state": "OK",
"postal_code": "741459212",
"telephone_number": "918-591-3897"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DONICA",
"first_name": "KATHLEEN",
"middle_name": "MATIE",
"credential": "A.T.,C.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-04-15",
"last_updated": "2008-04-15",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "OK",
"license": "AT100",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tulsa, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.