Active NPI
Ryan Austin Michaelis, LAT, CAT
- Athletic Trainer
- Collierville, TN
National Provider Identifier
1528831765
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 3111
- Practice address
- 99 Market Center Dr
Collierville, TN 38017-6913 - Phone
- (901) 861-9610
- NPI assigned
- Oct 31, 2023
- Sex
- Male
- Sole proprietor
- Yes
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 | 3111 | TN | Primary |
Addresses
Primary practice location
99 Market Center Dr
Collierville, TN 38017-6913
Mailing address
1862 Swynford LN
Collierville, TN 38017-8874
Phone (901) 647-3016
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 |
|---|---|---|---|
| 3111 | TN | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1698710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1698710400000",
"number": "1528831765",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1862 SWYNFORD LN",
"city": "COLLIERVILLE",
"state": "TN",
"postal_code": "380178874",
"telephone_number": "901-647-3016"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "99 MARKET CENTER DR",
"city": "COLLIERVILLE",
"state": "TN",
"postal_code": "380176913",
"telephone_number": "901-861-9610"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MICHAELIS",
"first_name": "RYAN",
"middle_name": "AUSTIN",
"credential": "LAT, CAT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-10-31",
"last_updated": "2023-10-31",
"certification_date": "2023-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "TN",
"license": "3111",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Collierville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.