Individual provider Active NPI

Kaitlyn Elizabeth Tirpak

  • Student in an Organized Health Care Education/Training Program
  • Ravenna, OH
National Provider Identifier
1821544263
Registry record updated Aug 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
UA489730 Issued in OH
Practice address
6850 State Route 14
Ravenna, OH 44266-9401
Phone
(330) 296-7274
NPI assigned
Aug 26, 2016
Last updated
Aug 26, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X UA489730 OH
Student in an Organized Health Care Education/Training Program 390200000X UA489730 OH Primary

Addresses

Primary practice location

6850 State Route 14
Ravenna, OH 44266-9401

Mailing address

6850 State Route 14
Ravenna, OH 44266-9401
Phone (330) 296-7274

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

LicenseStateTypeSpecialty
UA489730OHMDStudent in an Organized Health Care Education/Training Program

NPI Registry JSON

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

{
    "created_epoch": "1472169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472169600000",
    "number": "1821544263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6850 STATE ROUTE 14",
            "city": "RAVENNA",
            "state": "OH",
            "postal_code": "442669401",
            "telephone_number": "330-296-7274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6850 STATE ROUTE 14",
            "city": "RAVENNA",
            "state": "OH",
            "postal_code": "442669401",
            "telephone_number": "330-296-7274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIRPAK",
        "first_name": "KAITLYN",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-26",
        "last_updated": "2016-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "OH",
            "license": "UA489730",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OH",
            "license": "UA489730",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ravenna, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 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.