Active NPI
Kevin Atkinson
- Athletic Trainer
- Kendall Park, NJ
National Provider Identifier
1922591379
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 004114
- Practice address
- 28 Terrier PL
Kendall Park, NJ 08824-1468 - Phone
- (732) 710-0240
- NPI assigned
- Jun 11, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 004114 | NY | Primary |
Addresses
Primary practice location
28 Terrier PL
Kendall Park, NJ 08824-1468
Mailing address
28 Terrier PL
Kendall Park, NJ 08824-1468
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 |
|---|---|---|---|
| 004114 | NY | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1528675200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1642550400000",
"number": "1922591379",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "28 TERRIER PL",
"city": "KENDALL PARK",
"state": "NJ",
"postal_code": "088241468"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "28 TERRIER PL",
"city": "KENDALL PARK",
"state": "NJ",
"postal_code": "088241468",
"telephone_number": "732-710-0240"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ATKINSON",
"first_name": "KEVIN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-06-11",
"last_updated": "2022-01-19",
"certification_date": "2022-01-19",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "NY",
"license": "004114",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kendall Park, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.