Kiara Ann Lebouton, LAT, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

3121-39 Issued in WI

Practice address

2400 E Capitol Dr
Appleton, WI 54911-8728

Phone

(920) 642-1313

NPI assigned

Oct 5, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1696464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696464000000",
    "number": "1790565711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "996 3RD ST APT 8B",
            "city": "MENASHA",
            "state": "WI",
            "postal_code": "549523258",
            "telephone_number": "920-642-1313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 E CAPITOL DR",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549118728",
            "telephone_number": "920-642-1313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEBOUTON",
        "first_name": "KIARA",
        "middle_name": "ANN",
        "credential": "LAT, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-05",
        "last_updated": "2023-10-05",
        "certification_date": "2023-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "WI",
            "license": "3121-39",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Margaret Lawler, BSN, RN, IBCLC
• Lawrence University of Wisconsin
• Emily B Lawton, LCSW
• Dessia J Laxton, APNP
• Mallory Mae Leanna
• Lederer Chiropractic, SC
• Matthew Z Lederer, D.C.
• Sheng Boualong Lee Yang, LCSW
• Anthony Kou Lee, PA-C
• Gaeun Lee

• Athletic Trainer in Appleton, WI
• Providers in Appleton, WI by specialty
• Athletic Trainer in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2023; 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.