Individual provider Active NPI

Mikayla Ann Menn

  • Athletic Trainer
  • Willoughby, OH
National Provider Identifier
1184092140
Registry record updated Sep 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
Practice address
37399 Bethany CT
Willoughby, OH 44094-6472
Phone
(440) 289-4666
NPI assigned
Sep 8, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

37399 Bethany CT
Willoughby, OH 44094-6472

Mailing address

37399 Bethany CT
Willoughby, OH 44094-6472
Phone (440) 289-4666

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

NPI Registry JSON

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

{
    "created_epoch": "1441670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441670400000",
    "number": "1184092140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37399 BETHANY CT",
            "city": "WILLOUGHBY",
            "state": "OH",
            "postal_code": "440946472",
            "telephone_number": "440-289-4666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37399 BETHANY CT",
            "city": "WILLOUGHBY",
            "state": "OH",
            "postal_code": "440946472",
            "telephone_number": "440-289-4666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENN",
        "first_name": "MIKAYLA",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-08",
        "last_updated": "2015-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willoughby, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2015; 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.