Active NPI
Katie Marie Kimmich, ATC
- Athletic Trainer
- Cedar Rapids, IA
National Provider Identifier
1861959488
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 00627
- Practice address
- 2205 Forest Dr SE
Cedar Rapids, IA 52403-1653 - Phone
- (319) 558-2161
- NPI assigned
- Mar 1, 2019
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 00627 | IA | Primary |
Addresses
Primary practice location
2205 Forest Dr SE
Cedar Rapids, IA 52403-1653
Mailing address
3906 B Ave NE
Cedar Rapids, IA 52402-5644
Phone (319) 654-6114
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 |
|---|---|---|---|
| 00627 | IA | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1551398400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1551398400000",
"number": "1861959488",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3906 B AVE NE",
"city": "CEDAR RAPIDS",
"state": "IA",
"postal_code": "524025644",
"telephone_number": "319-654-6114"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2205 FOREST DR SE",
"city": "CEDAR RAPIDS",
"state": "IA",
"postal_code": "524031653",
"telephone_number": "319-558-2161"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIMMICH",
"first_name": "KATIE",
"middle_name": "MARIE",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-03-01",
"last_updated": "2019-03-01",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "IA",
"license": "00627",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cedar Rapids, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.