Tara Nicole Dooley, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

2119 Issued in MN

Practice address

1536 Hewitt Ave
Saint Paul, MN 55104-1205

Phone

(651) 523-3094

NPI assigned

Feb 12, 2019

Sex

Male

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

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

{
    "created_epoch": "1549929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549929600000",
    "number": "1194281329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1536 HEWITT AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551041284",
            "telephone_number": "651-523-3094",
            "fax_number": "651-523-3094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1536 HEWITT AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551041205",
            "telephone_number": "651-523-3094"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4200 Dahlberg Dr",
            "address_purpose": "LOCATION",
            "city": "Golden Valley",
            "state": "MN",
            "postal_code": "554224840",
            "country_code": "US",
            "telephone_number": "952-847-4052",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOOLEY",
        "first_name": "TARA",
        "middle_name": "NICOLE",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-02-12",
        "last_updated": "2019-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MN",
            "license": "2119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anna Donoghue
• Lawrence T Donovan, DO
• Michelle Donovan, DNP, APRN, WHNP
• Shan Liang Dang Donovan
• Aaron William Dooley, C PED
• Nicole Jeanette Williams Doonan, M.D.
• Doorway Counseling Services LLC
• Margaret Whipple Doose, MD
• Ellen Lorraine Dore, MD
• Gail Chira Dorfman

• Athletic Trainer in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Athletic Trainer in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 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.