Active NPI
Michael J Hackett, ATR CSCS
- Athletic Trainer
- Wall Township, NJ
National Provider Identifier
1699934042
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 25MT00011500
- Practice address
- 1630 18TH Ave
Wall Township, NJ 07719-3744 - Phone
- (732) 556-2066
- NPI assigned
- Jun 2, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 25MT00011500 | NJ | Primary |
Addresses
Primary practice location
1630 18TH Ave
Wall Township, NJ 07719-3744
Mailing address
PO Box 1199
Wall High School
Wall, NJ 07719
Phone (732) 556-2066
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
| License | State | Type | Specialty |
|---|---|---|---|
| 25MT00011500 | NJ | MD | Athletic Trainer |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wall Township Board of Education | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Local Education Agency (LEA)
- Wall Township, NJ
- NPI 1891905188
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1212364800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1212364800000",
"number": "1699934042",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1199",
"address_2": "WALL HIGH SCHOOL",
"city": "WALL",
"state": "NJ",
"postal_code": "07719",
"telephone_number": "732-556-2066"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1630 18TH AVE",
"city": "WALL TOWNSHIP",
"state": "NJ",
"postal_code": "077193744",
"telephone_number": "732-556-2066"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HACKETT",
"first_name": "MICHAEL",
"middle_name": "J",
"name_prefix": "Mr.",
"credential": "ATR CSCS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-06-02",
"last_updated": "2008-06-02",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "NJ",
"license": "25MT00011500",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wall Township, NJ
- Sarah Gowen
- Leila Sharon Grayson, MD
- Great Atlantic & Pacific Tea Company Inc (A & P Pharmacy)
- Blair Rachel Gumnic, D.O.
- Hackensack Meridian Ambulatory Care, Inc (Meridian Subacute Rehabilitation)
- Thomas Everett Hackett, DO
- Hanger Prosthetics & Orthotics East Inc (Hanger Clinic)
- Kim Lee Hart, LCADC
- Joseph Robert Harvey
- Tara Joan Healy, P.T.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.