Mackenzie Bloxham, MAT, LAT, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

2000051989 Issued in UT

Practice address

1 William L Jones Dr
Cookeville, TN 38505-0001

Phone

(931) 372-3101

NPI assigned

Jan 9, 2025

Last updated

Jan 9, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1736380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736380800000",
    "number": "1629888938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 E VETERANS DR APT B101",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385014699",
            "telephone_number": "435-512-0372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 WILLIAM L JONES DR",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385050001",
            "telephone_number": "931-372-3101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOXHAM",
        "first_name": "MACKENZIE",
        "credential": "MAT, LAT, ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-01-09",
        "last_updated": "2025-01-09",
        "certification_date": "2025-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "UT",
            "license": "2000051989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stacey Rene Blackmon, PHARMD
• Joseph Hayden Blalock, DMD
• Sara Makayla Blaylock
• Linda Carol Blazina, PH.D.
• Olivia Blevins, BEHAVIOR TECHNICIAN
• Britnie Bobrick, PHARMD
• Kyndell Boehms, MA, BCBA LBA
• Barry Boggs
• Leslie Bohn, MA
• Sarah N Boles, COTA

• Athletic Trainer in Cookeville, TN
• Providers in Cookeville, TN by specialty
• Athletic Trainer in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 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.

Verify at the official NPI Registry.