McKenzie Sara Owens, ATC, EMT

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

1352 Issued in CT

Practice address

275 Mount Carmel Ave
Hamden, CT 06518-1908

Phone

(203) 824-9044

Fax

(203) 582-3207

NPI assigned

Jul 12, 2018

Last updated

May 28, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• McKenzie Sara Miessau Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Emergency Medical Technician

State licenses

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

{
    "created_epoch": "1531353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716854400000",
    "number": "1326524471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 HAMPTON RD",
            "city": "EAST HAVEN",
            "state": "CT",
            "postal_code": "06512",
            "telephone_number": "203-824-9044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 MOUNT CARMEL AVE",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065181908",
            "telephone_number": "203-824-9044",
            "fax_number": "203-582-3207"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "181 White St",
            "address_purpose": "LOCATION",
            "city": "Danbury",
            "state": "CT",
            "postal_code": "068106826",
            "country_code": "US",
            "telephone_number": "203-824-9044",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OWENS",
        "first_name": "MCKENZIE",
        "middle_name": "SARA",
        "credential": "ATC, EMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-12",
        "last_updated": "2024-05-28",
        "certification_date": "2024-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "CT",
            "license": "1352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MCKENZIE",
            "last_name": "MIESSAU",
            "middle_name": "SARA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Our Village LLC
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• Randall Lee Owen, PA-C
• Janice Owens-Lane, PH.D
• Madelyn Dawn Owens, LMSW
• Tia Angelita Owens I
• Mildred Oxilas, DC
• Jennifer Oziol, PHARMD
• P. Renee Alberino, L.L.C.
• Pace Chiropractic Wellness Center, LLC

• Athletic Trainer in Hamden, CT
• Providers in Hamden, CT by specialty
• Athletic Trainer in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 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.