Individual provider Active NPI

Katie Stiles, ATC, LMT

  • Athletic Trainer
  • Jacobsburg, OH
National Provider Identifier
1912366378
Registry record updated Nov 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
AT.004707 Issued in OH
Practice address
49383 Sheba Rd
Jacobsburg, OH 43933-9604
Phone
(740) 310-6683
NPI assigned
Feb 15, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2020

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 AT.004707 OH Primary

Addresses

Primary practice location

49383 Sheba Rd
Jacobsburg, OH 43933-9604

Mailing address

41490 Brown Rd
Bethesda, OH 43719-9701
Phone (740) 310-6683

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

LicenseStateTypeSpecialty
AT.004707OHMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1455494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605398400000",
    "number": "1912366378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41490 BROWN RD",
            "city": "BETHESDA",
            "state": "OH",
            "postal_code": "437199701",
            "telephone_number": "740-310-6683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49383 SHEBA RD",
            "city": "JACOBSBURG",
            "state": "OH",
            "postal_code": "439339604",
            "telephone_number": "740-310-6683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STILES",
        "first_name": "KATIE",
        "credential": "ATC, LMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-15",
        "last_updated": "2020-11-15",
        "certification_date": "2020-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "OH",
            "license": "AT.004707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacobsburg, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2020; 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.