Active NPI
Anthony Kebede
- Athletic Trainer
- Greencastle, IN
National Provider Identifier
1811597024
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 2000015372
- Practice address
- 1780 E US Highway 40
Greencastle, IN 46135-8722 - Phone
- (260) 437-5834
- NPI assigned
- Oct 27, 2020
- Sex
- Male
- 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 | 2000015372 | IL | Primary |
Addresses
Primary practice location
1780 E US Highway 40
Greencastle, IN 46135-8722
Mailing address
2924 Harrison Ave
Terre Haute, IN 47803-3731
Phone (260) 437-5834
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 |
|---|---|---|---|
| 2000015372 | IL | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1603756800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603756800000",
"number": "1811597024",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2924 HARRISON AVE",
"city": "TERRE HAUTE",
"state": "IN",
"postal_code": "478033731",
"telephone_number": "260-437-5834"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1780 E US HIGHWAY 40",
"city": "GREENCASTLE",
"state": "IN",
"postal_code": "461358722",
"telephone_number": "260-437-5834"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KEBEDE",
"first_name": "ANTHONY",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-10-27",
"last_updated": "2020-10-27",
"certification_date": "2020-10-27",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "IL",
"license": "2000015372",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Greencastle, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.