Micheal Ray Gaddie, M.S., A.T.,C

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AT218 Issued in KY

Practice address

1906 College Heights Blvd
Bowling Green, KY 42101-1000

Phone

(270) 745-5317

NPI assigned

Mar 9, 2007

Sex

Male

Sole proprietor

Yes

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

Credentials

Master of Science

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Western Kentucky University

  • Student Health Clinic/Center
  • Bowling Green, KY
  • NPI 1366733222
  NPD (past)
• Western Kentucky University Research Foundation, Inc.

  • Local Education Agency (LEA)
  • Bowling Green, KY
  • NPI 1669506762
  NPD (past)

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1275664153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "592 FARMER LN",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421048546",
            "telephone_number": "270-745-5317",
            "fax_number": "270-745-2412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1906 COLLEGE HEIGHTS BLVD",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421011000",
            "telephone_number": "270-745-5317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GADDIE",
        "first_name": "MICHEAL",
        "middle_name": "RAY",
        "credential": "M.S., A.T.,C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "KY",
            "license": "AT218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Carlton Furrow, BSW
• Anita Fuston
• Pinky Dalal Gaba, MD
• Glenda Francis Gabhart, LCSW
• Emily Gaddie, COTA/L
• Tia Gadson
• Peter James Gagnon, DPT
• Carlos J Gaibor, MD
• Elizabeth Gaines, RBT
• Justin Reid Gallagher, OT

• All providers in Bowling Green, KY
• Athletic Trainer in Kentucky

• 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.

Verify at the official NPI Registry.