Individual provider Active NPI

John Michel

  • Athletic Trainer
  • Oxford, MS
National Provider Identifier
1376199943
Registry record updated Aug 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
AT0909 Issued in MS
Practice address
8 Gum Tree Dr
Oxford, MS 38655-6175
Phone
(715) 209-7987
NPI assigned
Aug 10, 2019
Last updated
Aug 10, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2019

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 AT0909 MS Primary

Addresses

Primary practice location

8 Gum Tree Dr
Oxford, MS 38655-6175

Mailing address

8 Gum Tree Dr
Oxford, MS 38655-6175

Other identifiers 1

IdentifierTypeStateIssuer
2000016781OtherCERTIFICATION NUMBER

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
AT0909MSMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1565395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565395200000",
    "number": "1376199943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 GUM TREE DR",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386556175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 GUM TREE DR",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386556175",
            "telephone_number": "715-209-7987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHEL",
        "first_name": "JOHN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-10",
        "last_updated": "2019-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MS",
            "license": "AT0909",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CERTIFICATION NUMBER",
            "identifier": "2000016781",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oxford, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2019; 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.