Active NPI
Stephanie Michelle Keiningham, LAT
- Athletic Trainer
- Cedar Park, TX
National Provider Identifier
1871900282
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AT1422
- Practice address
- 701 N Vista Ridge Blvd
#19101
Cedar Park, TX 78613-7844 - Phone
- (512) 573-9005
- NPI assigned
- Jul 17, 2014
- 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 | AT1422 | TX | Primary |
Addresses
Primary practice location
701 N Vista Ridge Blvd
#19101
Cedar Park, TX 78613-7844
Mailing address
701 N Vista Ridge Blvd
#19101
Cedar Park, TX 78613-7844
Phone (512) 573-9005
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 |
|---|---|---|---|
| AT1422 | TX | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1405555200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1405555200000",
"number": "1871900282",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "701 N VISTA RIDGE BLVD",
"address_2": "#19101",
"city": "CEDAR PARK",
"state": "TX",
"postal_code": "786137844",
"telephone_number": "512-573-9005"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "701 N VISTA RIDGE BLVD",
"address_2": "#19101",
"city": "CEDAR PARK",
"state": "TX",
"postal_code": "786137844",
"telephone_number": "512-573-9005"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KEININGHAM",
"first_name": "STEPHANIE",
"middle_name": "MICHELLE",
"name_prefix": "Ms.",
"credential": "LAT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-07-17",
"last_updated": "2014-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "TX",
"license": "AT1422",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cedar Park, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.