Active NPI
Colin Michael Szabo Mulligan, ATC
- Athletic Trainer
- Corvallis, OR
National Provider Identifier
1326670548
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- BOC153830
- Practice address
- 236 Kerr Administration BLDG
Corvallis, OR 97331-8578 - Phone
- (559) 396-5794
- NPI assigned
- Feb 5, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | BOC153830 | OR | Primary |
Addresses
Primary practice location
236 Kerr Administration BLDG
Corvallis, OR 97331-8578
Mailing address
3093 Main St Apt 324
Philomath, OR 97370-2128
Phone (559) 396-5794
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
| License | State | Type | Specialty |
|---|---|---|---|
| BOC153830 | OR | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1580860800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1580860800000",
"number": "1326670548",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3093 MAIN ST APT 324",
"city": "PHILOMATH",
"state": "OR",
"postal_code": "973702128",
"telephone_number": "559-396-5794"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "236 KERR ADMINISTRATION BLDG",
"city": "CORVALLIS",
"state": "OR",
"postal_code": "973318578",
"telephone_number": "559-396-5794"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MULLIGAN",
"first_name": "COLIN",
"middle_name": "MICHAEL SZABO",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-02-05",
"last_updated": "2020-02-05",
"certification_date": "2020-02-05",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "OR",
"license": "BOC153830",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Corvallis, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.