Katherine Lee Moos, MA, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

67002433 Issued in NY

Practice address

1533 S Main St
Winston Salem, NC 27127-2738

Phone

(336) 631-1512

NPI assigned

Jul 13, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Katherine Lee Heckenbach Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1405209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651190400000",
    "number": "1942617840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1533 S MAIN ST",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271272738",
            "telephone_number": "336-631-1512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1533 S MAIN ST",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271272738",
            "telephone_number": "336-631-1512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOOS",
        "first_name": "KATHERINE",
        "middle_name": "LEE",
        "credential": "MA, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-13",
        "last_updated": "2022-04-29",
        "certification_date": "2022-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NY",
            "license": "67002433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "moosk@uncsa.edu",
            "affiliation": "N",
            "address_1": "1533 S Main St",
            "city": "Winston Salem",
            "state": "NC",
            "country_code": "US",
            "postal_code": "271272738",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KATHERINE",
            "last_name": "HECKENBACH",
            "middle_name": "LEE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Zachary Ryan Moore, MD
• Moore'S Retirement Home, Inc
• Monica Billings Moorefield, RD, LDN
• Moores Retirement Home Inc
• Caitlin M Moorman Spangler, PHARMD
• Tyler Scott Moos, ATC
• Beverly Dawn Moose, MD
• Melissa Moose, OT
• Shahriar Moossavi, MD
• Lorenzo Luis Morales, MS, PTA, ATC-L

• Athletic Trainer in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Athletic Trainer in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 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.

Verify at the official NPI Registry.