Mackenzie Underwood, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

24-00789 Issued in KS

Practice address

12345 E 21St St N
Wichita, KS 67206-3503

Phone

(316) 634-0909

NPI assigned

Nov 16, 2020

Last updated

Nov 16, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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": "1605484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605484800000",
    "number": "1760084552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1942 N WOOD CT",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672125321",
            "telephone_number": "316-633-3433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12345 E 21ST ST N",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672063503",
            "telephone_number": "316-634-0909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UNDERWOOD",
        "first_name": "MACKENZIE",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-16",
        "last_updated": "2020-11-16",
        "certification_date": "2020-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "KS",
            "license": "24-00789",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATA",
            "identifier": "41774",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "ATS",
            "affiliation": "N",
            "address_1": "12345 E 21st St N",
            "city": "Wichita",
            "state": "KS",
            "country_code": "US",
            "postal_code": "672063503",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Cora Jean Underwood, COTA
• Natalie R Ungles, APRN
• Unified Care Homes, Inc.
• Unified School District 259
• Unimed II, Inc. (Unimed)
• Unique Feet Pedorthics Inc

• Athletic Trainer in Wichita, KS
• Providers in Wichita, KS by specialty
• Athletic Trainer in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 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.