Individual provider Active NPI

Megan Marcelle Hacker, ATC, LAT

  • Athletic Trainer
  • Chattanooga, TN
National Provider Identifier
1598219461
Registry record updated Mar 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
2625 Issued in TN
Practice address
1608 Gunbarrel Rd Ste 103
Chattanooga, TN 37421-7244
Phone
(423) 892-8070
Fax
(423) 893-9891
NPI assigned
Aug 9, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 2, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X AT6817 TX
Athletic Trainer 2255A2300X BOC310111 TN
Athletic Trainer 2255A2300X 2625 TN Primary

Addresses

Primary practice location

1608 Gunbarrel Rd Ste 103
Chattanooga, TN 37421-7244

Mailing address

6397 Lee Hwy Ste 300
Chattanooga, TN 37421-4915
Phone (423) 238-8930

Other practice location 1

2614 N University Dr
Apt 26
Nacogdoches, TX 75965-2966
Phone (615) 973-9533

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

LicenseStateTypeSpecialty
2625TNMDPediatric Dentist
BOC310111TNMDAthletic Trainer
AT6817TXMDAthletic Trainer

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1470700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583107200000",
    "number": "1598219461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6397 LEE HWY STE 300",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374214915",
            "telephone_number": "423-238-8930",
            "fax_number": "423-254-5217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1608 GUNBARREL RD STE 103",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374217244",
            "telephone_number": "423-892-8070",
            "fax_number": "423-893-9891"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2614 N University Dr",
            "address_2": "Apt 26",
            "address_purpose": "LOCATION",
            "city": "Nacogdoches",
            "state": "TX",
            "postal_code": "759652966",
            "country_code": "US",
            "telephone_number": "615-973-9533",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HACKER",
        "first_name": "MEGAN",
        "middle_name": "MARCELLE",
        "credential": "ATC, LAT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-09",
        "last_updated": "2020-03-02",
        "certification_date": "2020-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "TX",
            "license": "AT6817",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "TN",
            "license": "BOC310111",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "TN",
            "license": "2625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2020; 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.