Nicole Anne Kandra, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

251410 Issued in AK

Practice address

4076 Neely Rd
Fort Wainwright, AK 99703

Phone

(907) 361-5172

NPI assigned

Sep 25, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

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": "1443139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775606400000",
    "number": "1922478593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5623 MASON LN",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976019379",
            "telephone_number": "541-591-4719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4076 NEELY RD",
            "city": "FORT WAINWRIGHT",
            "state": "AK",
            "postal_code": "99703",
            "telephone_number": "907-361-5172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANDRA",
        "first_name": "NICOLE",
        "middle_name": "ANNE",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-25",
        "last_updated": "2026-04-08",
        "certification_date": "2026-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "OR",
            "license": "AT-AT-10197732",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "HI",
            "license": "251",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "WA",
            "license": "A160804654",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "AK",
            "license": "251410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cornelia F Jones, PHD
• Michael D Jones, PA-C
• James Alexander Jordan, MD
• Benjy Jose, FNP
• Melissa LMC Joseph
• Shelly Karg, LCSW
• Joshua Karrer, DPT
• Laura Nowels Kaster, M.D.
• Laurence Preston Keim, PA-C
• Kate Kimes, D.O.

• Athletic Trainer in Fort Wainwright, AK
• Providers in Fort Wainwright, AK by specialty
• Athletic Trainer in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2026; 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.