Active NPI
Kathryn Fitzgerald
- Athletic Trainer
- Williamsburg, VA
National Provider Identifier
1922533090
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 0126003095
- Practice address
- 751 Ukrop Way
Williamsburg, VA 23185 - Phone
- (802) 578-5533
- NPI assigned
- Apr 26, 2017
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | AT1409 | KY | |
| Athletic Trainer | 2255A2300X | 003468 | NY | |
| Athletic Trainer | 2255A2300X | 0126003095 | VA | Primary |
Addresses
Primary practice location
751 Ukrop Way
Williamsburg, VA 23185
Mailing address
3803 E Steeplechase Way Apt H
Williamsburg, VA 23188-7837
Phone (802) 578-5533
Other practice location 1
2340 Grinstead Dr
#4
Louisville, KY 40204-2359
Phone (802) 578-5533
Other practice location 2
4400 Vestal Pkwy E
Vestal, NY 13850-3533
Phone (802) 578-5533
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 |
|---|---|---|---|
| AT1409 | KY | MD | Community Health Worker |
| 003468 | NY | MD | Athletic Trainer |
| 0126003095 | VA | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1493164800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1581638400000",
"number": "1922533090",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3803 E STEEPLECHASE WAY APT H",
"city": "WILLIAMSBURG",
"state": "VA",
"postal_code": "231887837",
"telephone_number": "802-578-5533"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "751 UKROP WAY",
"city": "WILLIAMSBURG",
"state": "VA",
"postal_code": "23185",
"telephone_number": "802-578-5533"
}
],
"practiceLocations": [
{
"address_1": "2340 Grinstead Dr",
"address_2": "#4",
"address_purpose": "LOCATION",
"city": "Louisville",
"state": "KY",
"postal_code": "402042359",
"country_code": "US",
"telephone_number": "802-578-5533",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "4400 Vestal Pkwy E",
"address_purpose": "LOCATION",
"city": "Vestal",
"state": "NY",
"postal_code": "138503533",
"country_code": "US",
"telephone_number": "802-578-5533",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FITZGERALD",
"first_name": "KATHRYN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-04-26",
"last_updated": "2020-02-14",
"certification_date": "2020-02-14",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": "KY",
"license": "AT1409",
"primary": false
},
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "NY",
"license": "003468",
"primary": false
},
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "VA",
"license": "0126003095",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Williamsburg, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 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.