Individual provider Active NPI

Mikayla Coghill, LAT, ATC

  • Athletic Trainer
  • Fredericksburg, VA
National Provider Identifier
1295427185
Registry record updated Jul 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
2908 Issued in AL
Practice address
307 Chancellor PL
Fredericksburg, VA 22401-2104
Phone
(540) 845-7570
NPI assigned
May 22, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Emergency Medicine) Physician 207PS0010X 2908 AL
Athletic Trainer 2255A2300X 2908 AL Primary

Addresses

Primary practice location

307 Chancellor PL
Fredericksburg, VA 22401-2104

Mailing address

307 Chancellor PL
Fredericksburg, VA 22401-2104
Phone (540) 845-7570

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": "1684713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721174400000",
    "number": "1295427185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 CHANCELLOR PL",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224012104",
            "telephone_number": "540-845-7570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 CHANCELLOR PL",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224012104",
            "telephone_number": "540-845-7570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COGHILL",
        "first_name": "MIKAYLA",
        "credential": "LAT, ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-22",
        "last_updated": "2024-07-17",
        "certification_date": "2024-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PS0010X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Sports Medicine",
            "state": "AL",
            "license": "2908",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "AL",
            "license": "2908",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericksburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2024; 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.