Individual provider Active NPI

Katie Mackovjak

  • Athletic Trainer
  • Bowling Green, OH
National Provider Identifier
1558739680
Registry record updated Sep 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
Practice address
145 S Enterprise St
Bowling Green, OH 43402-2913
Phone
(440) 655-5671
NPI assigned
Sep 6, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X Primary

Addresses

Primary practice location

145 S Enterprise St
Bowling Green, OH 43402-2913

Mailing address

145 S Enterprise St
Bowling Green, OH 43402-2913
Phone (440) 655-5671

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": "1441497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441497600000",
    "number": "1558739680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 S ENTERPRISE ST",
            "city": "BOWLING GREEN",
            "state": "OH",
            "postal_code": "434022913",
            "telephone_number": "440-655-5671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 S ENTERPRISE ST",
            "city": "BOWLING GREEN",
            "state": "OH",
            "postal_code": "434022913",
            "telephone_number": "440-655-5671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACKOVJAK",
        "first_name": "KATIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-06",
        "last_updated": "2015-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowling Green, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 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.

Verify at the official NPI Registry.