Individual provider Active NPI

Kelly Colbert, MS, ATC

  • Athletic Trainer
  • Utica, NY
National Provider Identifier
1891040655
Registry record updated Jul 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
000309 Issued in NY
Practice address
100 Seymour Rd
Utica, NY 13502-1311
Phone
(315) 792-7519
NPI assigned
Jul 18, 2012
Last updated
Jul 18, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 18, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 000309 NY Primary

Addresses

Primary practice location

100 Seymour Rd
Utica, NY 13502-1311

Mailing address

100 Seymour Rd
Utica, NY 13502-1311

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
000309NYMDPsychoanalyst

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1342569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342569600000",
    "number": "1891040655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 SEYMOUR RD",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135021311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 SEYMOUR RD",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135021311",
            "telephone_number": "315-792-7519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLBERT",
        "first_name": "KELLY",
        "credential": "MS, ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-18",
        "last_updated": "2012-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NY",
            "license": "000309",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Utica, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2012; 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.