Individual provider Active NPI

Mikaila Davis

  • Athletic Trainer
  • Fayetteville, AR
National Provider Identifier
1578922829
Registry record updated Feb 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
Practice address
1681 N Dawn Dr
Fayetteville, AR 72703-6096
Phone
(805) 748-4282
NPI assigned
Feb 15, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2016

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

1681 N Dawn Dr
Fayetteville, AR 72703-6096

Mailing address

1681 N Dawn Dr
Fayetteville, AR 72703-6096

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": "1455494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455494400000",
    "number": "1578922829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1681 N DAWN DR",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727036096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1681 N DAWN DR",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727036096",
            "telephone_number": "805-748-4282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "MIKAILA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-15",
        "last_updated": "2016-02-15",
        "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 Fayetteville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2016; 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.