Individual provider Active NPI

Kathryn Fitzgerald

  • Athletic Trainer
  • Williamsburg, VA
National Provider Identifier
1922533090
Registry record updated Feb 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
0126003095 Issued in VA
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

Updated by the provider on Feb 14, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
AT1409KYMDCommunity Health Worker
003468NYMDAthletic Trainer
0126003095VAMDAthletic 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.

Verify at the official NPI Registry.