Active NPI
Madilyn Hope Peters, LAT, ATC
- Athletic Trainer
- Scooba, MS
National Provider Identifier
1487426367
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 1147
- Practice address
- PO Box 158
Scooba, MS 39358-0158 - Phone
- (205) 614-2037
- NPI assigned
- Oct 24, 2023
- Last updated
- May 26, 2025
- 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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Athletic Trainer | 2255A2300X | 1147 | MS | Primary |
Addresses
Primary practice location
PO Box 158
Scooba, MS 39358-0158
Mailing address
11707 Belle Meade Cir
Northport, AL 35475-4899
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1147 | MS | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1698105600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1748217600000",
"number": "1487426367",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11707 BELLE MEADE CIR",
"city": "NORTHPORT",
"state": "AL",
"postal_code": "354754899"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "PO BOX 158",
"city": "SCOOBA",
"state": "MS",
"postal_code": "393580158",
"telephone_number": "205-614-2037"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERS",
"first_name": "MADILYN",
"middle_name": "HOPE",
"credential": "LAT, ATC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-10-24",
"last_updated": "2025-05-26",
"certification_date": "2025-05-26",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "MS",
"license": "1147",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Scooba, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.