Madilyn Hope Peters, LAT, ATC
Individual provider Active NPI Athletic Trainer · Scooba, MS
NPI 1487426367 · NPPES record last updated May 26, 2025
Key facts
- NPI
- 1487426367
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- License
- 1147 (MS)
- Practice address
- PO Box 158
Scooba, MS 39358-0158 - Phone
- (205) 614-2037
- NPI assigned
- Oct 24, 2023
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1147 | MS | MD | Athletic Trainer |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Athletic Trainer | 2255A2300X | 1147 | MS | Yes |
Addresses
Primary practice location
PO Box 158
Scooba, MS 39358-0158
Mailing address
11707 Belle Meade Cir
Northport, AL 35475-4899
Other providers in Scooba, MS
- Greater Meridian Health Clinic, Inc.
- Suzanne Hagar
- Qyhdijha Ivy
- Elizabeth McMahan
- Ryota Nakagi
- Dorothy Richardson
- Shannon Wilkins
All providers in Scooba, MS · Athletic Trainer in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 26, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.