Mikayla Louise Moyer, LAT, ATC
Individual provider Active NPI Athletic Trainer · Forest City, IA
NPI 1639638133 · NPPES record last updated Jan 14, 2021
Key facts
- NPI
- 1639638133
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- License
- 097770 (IA)
- Practice address
- 210 Bob Johnson Dr Apt 200
Forest City, IA 50436-2204 - Phone
- (319) 540-5904
- NPI assigned
- Mar 14, 2019
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 097770 | IA | MD | Athletic Trainer |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | IA | ||
| Athletic Trainer | 2255A2300X | 097770 | IA | Yes |
Addresses
Primary practice location
210 Bob Johnson Dr Apt 200
Forest City, IA 50436-2204
Mailing address
500 Fairfax Rd
Fairfax, IA 52228-9704
Phone (319) 540-5904
Other practice location 1
500 Fairfax Rd
Fairfax, IA 52228-9704
Phone (319) 540-5904
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mikayla.moyer@athletico.com |
Other providers in Forest City, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 14, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.