Active NPI
Madison Roskuszka
- Athletic Trainer
- Holland, MI
National Provider Identifier
1386037778
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- Practice address
- 141 E 12TH St
Devos Fieldhouse
Holland, MI 49423-3607 - Phone
- (616) 395-7098
- NPI assigned
- Mar 10, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | Primary | ||
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
141 E 12TH St
Devos Fieldhouse
Holland, MI 49423-3607
Mailing address
26W340 Thorngate LN
Winfield, IL 60190-2375
Phone (630) 408-8853
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1425945600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1425945600000",
"number": "1386037778",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "26W340 THORNGATE LN",
"city": "WINFIELD",
"state": "IL",
"postal_code": "601902375",
"telephone_number": "630-408-8853"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "141 E 12TH ST",
"address_2": "DEVOS FIELDHOUSE",
"city": "HOLLAND",
"state": "MI",
"postal_code": "494233607",
"telephone_number": "616-395-7098"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSKUSZKA",
"first_name": "MADISON",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-03-10",
"last_updated": "2015-03-10",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": null,
"license": null,
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Holland, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.