Active NPI
Mary McDonagh
- Athletic Trainer
- Dillon, MT
National Provider Identifier
1215390646
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- ATR-LAT-LIC-1225
- Practice address
- 710 S Atlantic St
Dillon, MT 59725-3511 - Phone
- (617) 283-8509
- NPI assigned
- Apr 2, 2016
- Sex
- Female
- Sole proprietor
- No
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 | ATR-LAT-LIC-1225 | MT | Primary |
Addresses
Primary practice location
710 S Atlantic St
Dillon, MT 59725-3511
Mailing address
100 W Glendale St Apt 2
Dillon, MT 59725-2478
Phone (617) 283-8509
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 |
|---|---|---|---|
| ATR-LAT-LIC-1225 | MT | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1459555200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1459555200000",
"number": "1215390646",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 W GLENDALE ST APT 2",
"city": "DILLON",
"state": "MT",
"postal_code": "597252478",
"telephone_number": "617-283-8509"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "710 S ATLANTIC ST",
"city": "DILLON",
"state": "MT",
"postal_code": "597253511",
"telephone_number": "617-283-8509"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCDONAGH",
"first_name": "MARY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-04-02",
"last_updated": "2016-04-02",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "MT",
"license": "ATR-LAT-LIC-1225",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dillon, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 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.