Karla Marie Halde, ATC, LAT

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

096.004582 Issued in IL

Practice address

4500 Memorial Dr
Belleville, IL 62226-5399

Phone

(618) 233-7750

NPI assigned

Mar 22, 2021

Last updated

Mar 22, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1616371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616371200000",
    "number": "1902482730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6908 LOYET RD",
            "city": "COLLINSVILLE",
            "state": "IL",
            "postal_code": "622346520",
            "telephone_number": "618-974-8489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 MEMORIAL DR",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622265399",
            "telephone_number": "618-233-7750"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 W Schuetz St",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "IL",
            "postal_code": "622541570",
            "country_code": "US",
            "telephone_number": "618-537-4423",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HALDE",
        "first_name": "KARLA",
        "middle_name": "MARIE",
        "credential": "ATC, LAT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-22",
        "last_updated": "2021-03-22",
        "certification_date": "2021-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IL",
            "license": "096.004582",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA HEALTH",
            "identifier": "U77716965",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "ATS",
            "affiliation": "N",
            "endpointDescription": "Athletic Training  System",
            "address_1": "4500 Memorial Dr",
            "city": "Belleville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "622265399",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Dean David Hageman, M.D.
• Matthew Dean Hageman, MD
• Ganan Hahn, PA
• Jay W Haines II, M.D.
• Stephanie Renee Haines, DMD
• Lauren Hall, RN MSN
• Joan Halwachs
• Karen Ann Ham, PA-C
• Derrick Hamilton, DC
• Kiara Ihomua Hamilton, RN

• Athletic Trainer in Belleville, IL
• Providers in Belleville, IL by specialty
• Athletic Trainer in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2021; 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.