Individual provider Active NPI

Madeleine Hauck, MAT, ATC

  • Athletic Trainer
  • Austin, TX
National Provider Identifier
1699200592
Registry record updated Oct 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
AT7411 Issued in TX
Practice address
5805 Arbor Pavillion LN
Austin, TX 78744-4433
Phone
(312) 259-1714
NPI assigned
Apr 27, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Athletic Trainer 2255A2300X AT7411 TX Primary

Addresses

Primary practice location

5805 Arbor Pavillion LN
Austin, TX 78744-4433

Mailing address

5805 Arbor Pavillion LN
Austin, TX 78744-4433
Phone (312) 259-1714

Other practice location 1

3416 Caroline St
Saint Louis, MO 63104-1112
Phone (312) 259-1714

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
AT7411TXMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1493251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602633600000",
    "number": "1699200592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5805 ARBOR PAVILLION LN",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787444433",
            "telephone_number": "312-259-1714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5805 ARBOR PAVILLION LN",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787444433",
            "telephone_number": "312-259-1714"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3416 Caroline St",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631041112",
            "country_code": "US",
            "telephone_number": "312-259-1714",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAUCK",
        "first_name": "MADELEINE",
        "credential": "MAT,  ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-27",
        "last_updated": "2020-10-14",
        "certification_date": "2020-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "TX",
            "license": "AT7411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 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.