Active NPI
Renee Candace Mickey, ATC, LAT, MS, PES
- Athletic Trainer
- Cookeville, TN
National Provider Identifier
1396366191
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 1777
- Practice address
- 89 Messenger Rd Apt C2
Cookeville, TN 38506-5781 - Phone
- (910) 995-5262
- NPI assigned
- May 3, 2020
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 1777 | TN | Primary |
Addresses
Primary practice location
89 Messenger Rd Apt C2
Cookeville, TN 38506-5781
Mailing address
89 Messenger Rd Apt C2
Cookeville, TN 38506-5781
Phone (910) 995-5262
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1777 | TN | MD | Anatomic Pathology & Clinical Pathology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1588464000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1588464000000",
"number": "1396366191",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "89 MESSENGER RD APT C2",
"city": "COOKEVILLE",
"state": "TN",
"postal_code": "385065781",
"telephone_number": "910-995-5262"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "89 MESSENGER RD APT C2",
"city": "COOKEVILLE",
"state": "TN",
"postal_code": "385065781",
"telephone_number": "910-995-5262"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MICKEY",
"first_name": "RENEE",
"middle_name": "CANDACE",
"name_prefix": "Ms.",
"credential": "ATC, LAT, MS, PES",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-05-03",
"last_updated": "2020-05-03",
"certification_date": "2020-05-03",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "TN",
"license": "1777",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cookeville, TN
- MH Health Care Services, PC
- Michael E. Cole MD, PLLC
- Michael S Pippin MD PC
- Anthony A Michael, LPC
- Christina Lasha Mick, LPC
- Mid-State Sports Medicine
- Middle Tennessee Eye Associates of Cookeville PLLC
- Middle Tennessee Surgical Specialists, LLC
- Logan James Miles
- Milk Guide Lactation of Tennessee LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 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.