Kristen McTernan, A.T.C

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AL4296 Issued in FL

Practice address

421 N Woodland Blvd
8317
Deland, FL 32723-8300

Phone

(386) 822-7167

Fax

(386) 738-6536

NPI assigned

Mar 15, 2016

Last updated

Mar 15, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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": "1458000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458000000000",
    "number": "1821459009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "421 N WOODLAND BLVD",
            "address_2": "8317",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327238300",
            "telephone_number": "386-822-7167",
            "fax_number": "386-738-6536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 N WOODLAND BLVD",
            "address_2": "8317",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327238300",
            "telephone_number": "386-822-7167",
            "fax_number": "386-738-6536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCTERNAN",
        "first_name": "KRISTEN",
        "credential": "A.T.C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-15",
        "last_updated": "2016-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "FL",
            "license": "AL4296",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ATHLETIC TRAINER FLORIDA LISCENSURE",
            "identifier": "AL4296",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Athletic Trainer in Deland, FL
• Providers in Deland, FL by specialty
• Athletic Trainer in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2016; 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.