Kristin Dawn Gubera, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

2014001993 Issued in MO

Practice address

809 N Wall Ave
Joplin, MO 64801-1166

Phone

(417) 439-5747

NPI assigned

Jul 4, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

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": "1467590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480118400000",
    "number": "1952753808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "809 N WALL AVE",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648011166",
            "telephone_number": "417-439-5747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "809 N WALL AVE",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648011166",
            "telephone_number": "417-439-5747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUBERA",
        "first_name": "KRISTIN",
        "middle_name": "DAWN",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-04",
        "last_updated": "2016-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MO",
            "license": "2014001993",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Raymond Grote, MD
• Amanda K Grounds, APRN, FNP-C
• Matthew Dwight Grounds, DO
• Kristine Marie Grove
• Cassandra Ann Groves, L-HIS
• Paulette Gudgeon
• Klacee Victoria Guernsey, APRN
• Jim Guhr, CRNA
• Maria Ivonne Guillen, HIS
• Eric Paul Guilliams, MD

• Athletic Trainer in Joplin, MO
• Providers in Joplin, MO by specialty
• Athletic Trainer in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2016; 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.