Active NPI
Michelle Winters
- Athletic Trainer
- Jackson, MI
National Provider Identifier
1003488479
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 2169100350
- Practice address
- 205 N East Ave
Jackson, MI 49201-1753 - Phone
- (517) 205-4800
- NPI assigned
- Jul 14, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 2169100350 | MI | Primary |
Addresses
Primary practice location
205 N East Ave
Jackson, MI 49201-1753
Mailing address
4185 Berkshire Blvd
Jackson, MI 49203-5114
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2169100350 | MI | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1626220800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1626220800000",
"number": "1003488479",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4185 BERKSHIRE BLVD",
"city": "JACKSON",
"state": "MI",
"postal_code": "492035114"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "205 N EAST AVE",
"city": "JACKSON",
"state": "MI",
"postal_code": "492011753",
"telephone_number": "517-205-4800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WINTERS",
"first_name": "MICHELLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-07-14",
"last_updated": "2021-07-14",
"certification_date": "2021-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "MI",
"license": "2169100350",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jackson, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.