Active NPI
Amy Michelle McKouen, ATC
- Athletic Trainer
- Auburn Hills, MI
National Provider Identifier
1043421688
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- Practice address
- 3100 Cross Creek Pkwy
Auburn Hills, MI 48326-2774 - Phone
- (248) 377-8000
- NPI assigned
- May 25, 2007
- 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 | MI | Primary |
Addresses
Primary practice location
3100 Cross Creek Pkwy
Auburn Hills, MI 48326-2774
Mailing address
15121 Western Valley Dr
Holly, MI 48442-1912
Phone (248) 634-8636
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 22 | Other | MI | ATC |
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 |
|---|---|---|---|
| 049502528 | MI | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1180051200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1043421688",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15121 WESTERN VALLEY DR",
"city": "HOLLY",
"state": "MI",
"postal_code": "484421912",
"telephone_number": "248-634-8636"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3100 CROSS CREEK PKWY",
"city": "AUBURN HILLS",
"state": "MI",
"postal_code": "483262774",
"telephone_number": "248-377-8000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCKOUEN",
"first_name": "AMY",
"middle_name": "MICHELLE",
"name_prefix": "Mrs.",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "MI",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ATC",
"identifier": "22",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Auburn Hills, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.