Active NPI
Nicole Lea Hahne, LATC
- Athletic Trainer
- Timber Lake, SD
National Provider Identifier
1184834558
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 0195
- Practice address
- 906 Main St
Timber Lake, SD 57656 - Phone
- (605) 865-3258
- NPI assigned
- May 23, 2007
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 | 0195 | SD | Primary |
Addresses
Primary practice location
906 Main St
Timber Lake, SD 57656
Mailing address
27380 SD Hwy 20
Trail City, SD 57657
Phone (605) 845-7004
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 |
|---|---|---|---|
| 0195 | SD | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179878400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1184834558",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "27380 SD HWY 20",
"city": "TRAIL CITY",
"state": "SD",
"postal_code": "57657",
"telephone_number": "605-845-7004"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "906 MAIN ST",
"city": "TIMBER LAKE",
"state": "SD",
"postal_code": "57656",
"telephone_number": "605-865-3258"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAHNE",
"first_name": "NICOLE",
"middle_name": "LEA",
"name_prefix": "Miss",
"credential": "LATC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "SD",
"license": "0195",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Timber Lake, SD
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.