Active NPI
Molly Kidd, ATC, LAT
- Athletic Trainer
- Leander, TX
National Provider Identifier
1851869499
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AT5148
- Practice address
- 1320 Collaborative Way
Leander, TX 78641-9081 - Phone
- (512) 570-1480
- NPI assigned
- Nov 12, 2018
- Last updated
- Nov 12, 2018
- Sex
- Female
- 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 | AT5148 | TX | Primary |
Addresses
Primary practice location
1320 Collaborative Way
Leander, TX 78641-9081
Mailing address
1412 Moss Creek Dr
Leander, TX 78641-2918
Phone (626) 826-5433
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 |
|---|---|---|---|
| AT5148 | TX | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1541980800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1541980800000",
"number": "1851869499",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1412 MOSS CREEK DR",
"city": "LEANDER",
"state": "TX",
"postal_code": "786412918",
"telephone_number": "626-826-5433"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1320 COLLABORATIVE WAY",
"city": "LEANDER",
"state": "TX",
"postal_code": "786419081",
"telephone_number": "512-570-1480"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIDD",
"first_name": "MOLLY",
"credential": "ATC, LAT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-11-12",
"last_updated": "2018-11-12",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "TX",
"license": "AT5148",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Leander, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 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.