Individual provider Active NPI

Sierra Hakanson

  • Athletic Trainer
  • Florence, AL
National Provider Identifier
1114505286
Registry record updated Mar 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
2461 Issued in AL
Practice address
1 Harrison PLZ
Florence, AL 35632-0002
Phone
(256) 765-5020
NPI assigned
Mar 31, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X ATR-009176 AZ
Athletic Trainer 2255A2300X AT-AT-10201714 OR
Athletic Trainer 2255A2300X 2461 AL Primary

Addresses

Primary practice location

1 Harrison PLZ
Florence, AL 35632-0002

Mailing address

77836 Mosby Creek Rd
Cottage Grove, OR 97424-9446
Phone (541) 915-8099

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

LicenseStateTypeSpecialty
2461ALMDSpecialist
ATR-009176AZMDAthletic Trainer
AT-AT-10201714ORMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1617148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617148800000",
    "number": "1114505286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77836 MOSBY CREEK RD",
            "city": "COTTAGE GROVE",
            "state": "OR",
            "postal_code": "974249446",
            "telephone_number": "541-915-8099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HARRISON PLZ",
            "city": "FLORENCE",
            "state": "AL",
            "postal_code": "356320002",
            "telephone_number": "256-765-5020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAKANSON",
        "first_name": "SIERRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-31",
        "last_updated": "2021-03-31",
        "certification_date": "2021-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "AZ",
            "license": "ATR-009176",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "OR",
            "license": "AT-AT-10201714",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "AL",
            "license": "2461",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Florence, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 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.

Verify at the official NPI Registry.