Amanda Kristine Roberts, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AT002410 Issued in GA

Practice address

1493 Highway 92
Acworth, GA 30102

Phone

(716) 515-8296

NPI assigned

Oct 9, 2018

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 names 1

• Amanda Kristine Oberle Other name

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": "1539043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539043200000",
    "number": "1821563677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "244 DERBY CT",
            "city": "ACWORTH",
            "state": "GA",
            "postal_code": "301021438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1493 HIGHWAY 92",
            "city": "ACWORTH",
            "state": "GA",
            "postal_code": "30102",
            "telephone_number": "716-515-8296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "AMANDA",
        "middle_name": "KRISTINE",
        "name_prefix": "Mrs.",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-09",
        "last_updated": "2018-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "GA",
            "license": "AT002410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "OBERLE",
            "middle_name": "KRISTINE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Nera E Richardson
• Anna Riley
• Amy Marie Nelson Rivera, M.S., L.P.C.
• Bryan Rivera, ATC, LAT
• Gordon Todd Robbins, M.D.
• May Amanukpo Robinson, MD
• Brenna Renee Roden, DC
• Candice Rolle
• Raven Paulette Rose, PA
• Richard Martin Rosenberger, M.D.

• Athletic Trainer in Acworth, GA
• Providers in Acworth, GA by specialty
• Athletic Trainer in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2018; 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.