Individual provider Active NPI

Madison Durocher, MS, LAT, ATC

  • Athletic Trainer
  • Bedford, TX
National Provider Identifier
1336607779
Registry record updated May 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
Practice address
2425 Highway 121
Bedford, TX 76021-5013
Phone
(817) 540-4477
NPI assigned
Mar 5, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2024

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 Primary

Addresses

Primary practice location

2425 Highway 121
Bedford, TX 76021-5013

Mailing address

2500 State Highway 121 Apt 1633
Euless, TX 76039-6041
Phone (774) 722-4967

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
Credentials
Master of Science

NPI Registry JSON

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

{
    "created_epoch": "1551744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715299200000",
    "number": "1336607779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 STATE HIGHWAY 121 APT 1633",
            "city": "EULESS",
            "state": "TX",
            "postal_code": "760396041",
            "telephone_number": "774-722-4967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2425 HIGHWAY 121",
            "city": "BEDFORD",
            "state": "TX",
            "postal_code": "760215013",
            "telephone_number": "817-540-4477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUROCHER",
        "first_name": "MADISON",
        "credential": "MS, LAT, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-05",
        "last_updated": "2024-05-10",
        "certification_date": "2024-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bedford, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 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.