Individual provider Active NPI

McKenna Alexandra Newell, ATC

  • Athletic Trainer
  • Phoenix, AZ
National Provider Identifier
1174185128
Registry record updated Jun 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
001630 Issued in AZ
Practice address
3300 W Camelback Rd
Phoenix, AZ 85017-3030
Phone
(760) 567-3555
NPI assigned
Jun 30, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 001630 AZ Primary

Addresses

Primary practice location

3300 W Camelback Rd
Phoenix, AZ 85017-3030

Mailing address

3411 N 16TH St Apt 2097
Phoenix, AZ 85016-7177
Phone (760) 567-3555

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
001630AZMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1561852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561852800000",
    "number": "1174185128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3411 N 16TH ST APT 2097",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850167177",
            "telephone_number": "760-567-3555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 W CAMELBACK RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850173030",
            "telephone_number": "760-567-3555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEWELL",
        "first_name": "MCKENNA",
        "middle_name": "ALEXANDRA",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-30",
        "last_updated": "2019-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "AZ",
            "license": "001630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2019; 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.