Active NPI
Taylor Nicole Austin
- Athletic Trainer
- Grand Rapids, MI
National Provider Identifier
1215563440
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- Practice address
- 3101 Leonard St NE
Grand Rapids, MI 49525-5832 - Phone
- (269) 204-8246
- NPI assigned
- Mar 19, 2020
- 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 | MI | Primary |
Addresses
Primary practice location
3101 Leonard St NE
Grand Rapids, MI 49525-5832
Mailing address
6921 Cambridge
Shelbyville, MI 49344-9600
Phone (269) 204-8246
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": "1584576000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1584576000000",
"number": "1215563440",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6921 CAMBRIDGE",
"city": "SHELBYVILLE",
"state": "MI",
"postal_code": "493449600",
"telephone_number": "269-204-8246"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3101 LEONARD ST NE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495255832",
"telephone_number": "269-204-8246"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AUSTIN",
"first_name": "TAYLOR",
"middle_name": "NICOLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-03-19",
"last_updated": "2020-03-19",
"certification_date": "2020-03-19",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "MI",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.