Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Keita Shimada, MK, LAT, ATC

Individual provider Specialist · NPI 1386053213

Mr. Keita Shimada, MK, LAT, ATC is a Specialist in Boise, Idaho. Licensed in Idaho. Registered with an NPI since 2014.

Licensed in
ID
In the registry since
2014
What do these letters mean?
LAT — Licensed Athletic Trainer
A state-licensed athletic trainer.
ATC — Certified Athletic Trainer
Prevents and treats sport and activity injuries.

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Practice location Address checks out

1910 University Dr # MS 1020
Boise, ID 83725-0001
Phone: (208) 407-6526
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Specialist (primary) Taxonomy 174400000X · Licence AT-334 (ID)

Record details

NPI number1386053213
Entity typeIndividual (Type 1)
GenderMale
Credentials MK , LAT , ATC
Sole proprietorNo
NPI enumeratedAugust 5, 2014
Last updated in NPPESAugust 5, 2014

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