Individual provider Active NPI

Michael Aidan Mullarkey

  • Athletic Trainer
  • East Lansing, MI
National Provider Identifier
1255277943
Registry record updated Apr 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
Practice address
771 Chestnut Rd
East Lansing, MI 48824-3434
Phone
(847) 977-9107
NPI assigned
Apr 27, 2026
Last updated
Apr 27, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X MI Primary

Addresses

Primary practice location

771 Chestnut Rd
East Lansing, MI 48824-3434

Mailing address

1025 Evergreen Dr
Lake Forest, IL 60045-4300
Phone (847) 977-9107

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": "1777248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777248000000",
    "number": "1255277943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 EVERGREEN DR",
            "city": "LAKE FOREST",
            "state": "IL",
            "postal_code": "600454300",
            "telephone_number": "847-977-9107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "771 CHESTNUT RD",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488243434",
            "telephone_number": "847-977-9107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLARKEY",
        "first_name": "MICHAEL",
        "middle_name": "AIDAN",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-04-27",
        "last_updated": "2026-04-27",
        "certification_date": "2026-04-26",
        "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 East Lansing, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2026; 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.