Individual provider Active NPI

Kayleigh De Koker, MS, LAT, ATC

  • Athletic Trainer
  • Terre Haute, IN
National Provider Identifier
1972314581
Registry record updated Jan 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
36003900A Issued in IN
Practice address
401 N 4TH St
Terre Haute, IN 47809-1934
Phone
(808) 651-3042
NPI assigned
Jan 15, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 36003900A IN Primary

Addresses

Primary practice location

401 N 4TH St
Terre Haute, IN 47809-1934

Mailing address

101 Crawford St Apt 407
Terre Haute, IN 47807-4657
Phone (423) 331-8848

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
36003900AINMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1736899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736899200000",
    "number": "1972314581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 CRAWFORD ST APT 407",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478074657",
            "telephone_number": "423-331-8848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 N 4TH ST",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478091934",
            "telephone_number": "808-651-3042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE KOKER",
        "first_name": "KAYLEIGH",
        "name_prefix": "Ms.",
        "credential": "MS, LAT, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-15",
        "last_updated": "2025-01-15",
        "certification_date": "2025-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IN",
            "license": "36003900A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Terre Haute, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2025; 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.