Taylor Mickelson, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AL 4197 Issued in FL

Practice address

5140 Gate Pkwy
2104
Jacksonville, FL 32256-0232

Phone

(501) 282-4145

NPI assigned

Apr 11, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1460332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460332800000",
    "number": "1134583602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5140 GATE PKWY",
            "address_2": "2104",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322560232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5140 GATE PKWY",
            "address_2": "2104",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322560232",
            "telephone_number": "501-282-4145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICKELSON",
        "first_name": "TAYLOR",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-11",
        "last_updated": "2016-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "FL",
            "license": "AL 4197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle McLanahan, M.D., P.a.
• Jan K Michelsen, APRN
• Thomas A Michelsen, DO
• Jenna Michelson, LCSW
• Janice Valerio Miciano, APRN
• Jada Mickens
• Sabrina Mickens
• Melanie Reynolds Mickey, LMHC
• William Robert Mickle, APRN
• Brent S Mickley, PA

• All providers in Jacksonville, FL
• Athletic Trainer in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2016; 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.