Individual provider Active NPI

Michael Heichel, MA, AT

  • Athletic Trainer
  • Mogadore, OH
National Provider Identifier
1376990812
Registry record updated May 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
AT-1506 Issued in OH
Practice address
1485 Congress Lake Rd
Mogadore, OH 44260-1924
Phone
(330) 730-1686
NPI assigned
May 14, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 14, 2016

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 AT-1506 OH Primary

Addresses

Primary practice location

1485 Congress Lake Rd
Mogadore, OH 44260-1924

Mailing address

1485 Congress Lake Rd
Mogadore, OH 44260-1924

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 Arts

State licenses

LicenseStateTypeSpecialty
AT-1506OHMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1463184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463184000000",
    "number": "1376990812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1485 CONGRESS LAKE RD",
            "city": "MOGADORE",
            "state": "OH",
            "postal_code": "442601924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1485 CONGRESS LAKE RD",
            "city": "MOGADORE",
            "state": "OH",
            "postal_code": "442601924",
            "telephone_number": "330-730-1686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEICHEL",
        "first_name": "MICHAEL",
        "credential": "MA, AT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-05-14",
        "last_updated": "2016-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "OH",
            "license": "AT-1506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mogadore, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2016; 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.