Individual provider Active NPI

Dayna Elizabeth McKilligin, ATC

  • Athletic Trainer
  • Monroe, WI
National Provider Identifier
1275974404
Registry record updated Jun 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
1480-39 Issued in WI
Practice address
515 22ND Ave
Monroe, WI 53566-1569
Phone
(608) 352-7529
Fax
(608) 324-1214
NPI assigned
Jul 16, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2014

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 1480-39 WI Primary

Addresses

Primary practice location

515 22ND Ave
Monroe, WI 53566-1569

Mailing address

4013 Sandstone Drive
Janesville, WI 53546-1569
Phone (608) 774-0928

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

LicenseStateTypeSpecialty
1480-39WIMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1373932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403568000000",
    "number": "1275974404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4013 SANDSTONE DRIVE",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535461569",
            "telephone_number": "608-774-0928",
            "fax_number": "608-324-1214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 22ND AVE",
            "city": "MONROE",
            "state": "WI",
            "postal_code": "535661569",
            "telephone_number": "608-352-7529",
            "fax_number": "608-324-1214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKILLIGIN",
        "first_name": "DAYNA",
        "middle_name": "ELIZABETH",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-16",
        "last_updated": "2014-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "WI",
            "license": "1480-39",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2014; 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.