Active NPI
Kaelin Brett Kohles, LAT, ATC
- Athletic Trainer
- Mandeville, LA
National Provider Identifier
1861935520
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 305551
- Practice address
- 2810 E Causeway Approach
Mandeville, LA 70448-3502 - Phone
- (985) 875-2340
- NPI assigned
- Nov 29, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | A | ||
| Athletic Trainer | 2255A2300X | 305551 | LA | Primary |
Addresses
Primary practice location
2810 E Causeway Approach
Mandeville, LA 70448-3502
Mailing address
PO Box 256
Loranger, LA 70446-0256
Phone (985) 981-3750
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 |
|---|---|---|---|
| 305551 | LA | MD | Athletic Trainer |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Foundation for the Advancement of a Strategic Science of Teaching | Past | Accepting new patients | |
| Nicholls State University | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
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- NPI 1295227635
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1480377600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1664928000000",
"number": "1861935520",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 256",
"city": "LORANGER",
"state": "LA",
"postal_code": "704460256",
"telephone_number": "985-981-3750"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2810 E CAUSEWAY APPROACH",
"city": "MANDEVILLE",
"state": "LA",
"postal_code": "704483502",
"telephone_number": "985-875-2340"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOHLES",
"first_name": "KAELIN",
"middle_name": "BRETT",
"credential": "LAT, ATC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-11-29",
"last_updated": "2022-10-05",
"certification_date": "2022-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": "A",
"primary": false
},
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "LA",
"license": "305551",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mandeville, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.