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1174745558 NPI number — KRISTEN MARIE ADAMS MED, ATC, LAT

NPI Number: 1174745558
Health Care Provider/Practitioner: KRISTEN MARIE ADAMS MED, ATC, LAT

Information about “1174745558” NPI (KRISTEN MARIE ADAMS MED, ATC, LAT) exists in 1174745558 in HTML format HTML  |  1174745558 in plain Text format TXT  |  1174745558 in PDF (Portable Document Format) PDF  |  1174745558 in an XML format XML  formats.

NPI Number : 1174745558 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1174745558",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "ADAMS",
    "FirstName": "KRISTEN",
    "MiddleName": "MARIE",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "MED, ATC, LAT",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "85 W 1400 S",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "OREM",
    "MailingAddressStateName": "UT",
    "MailingAddressPostalCode": "84058-7429",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "512-665-0963",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "99 N THUNDER BLVD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "SARATOGA SPRINGS",
    "PracticeLocationAddressStateName": "UT",
    "PracticeLocationAddressPostalCode": "84045-3134",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "801-610-8815",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "05/03/2007",
    "LastUpdateDate": "08/04/2014",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "2255A2300X",
          "TaxonomyName": "Athletic Trainer",
          "LicenseNumber": "AT3224",
          "LicenseNumberStateCode": "TX",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "2255A2300X",
          "TaxonomyName": "Athletic Trainer",
          "LicenseNumber": "7728452-4810",
          "LicenseNumberStateCode": "UT",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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