Tiana McKim, LAT, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

1714469 Issued in DE

Practice address

631 S College Ave
Newark, DE 19716-2010

Phone

(302) 831-2196

NPI assigned

Sep 2, 2016

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

Other identifiers 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": "1472774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574035200000",
    "number": "1780131177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "631 S COLLEGE AVE",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197162010",
            "telephone_number": "302-831-2196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "631 S COLLEGE AVE",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197162010",
            "telephone_number": "302-831-2196"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4000 Central Florida Blvd",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328168005",
            "country_code": "US",
            "telephone_number": "302-377-4732",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCKIM",
        "first_name": "TIANA",
        "name_prefix": "Miss",
        "credential": "LAT, ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-02",
        "last_updated": "2019-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "DE",
            "license": "1714469",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EXAMINING BOARD OF PHYSICAL THERAPISTS AND ATHLETIC TRAINERS",
            "identifier": "1714469",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Richard C McKay, D.C.
• Travis McKay, DC
• Danielle B McKenna, LCGC
• Natalie McKenney, RDN
• Brenda Kay McKenzie, MSN
• Danielle McKnight, CRNA
• Stephen McLaren
• Jaime McLaughlin, AGACNP-BC
• Megan Leigh McMahon, PSY.D.
• Lauren Elizabeth McManus, PH.D.

• Athletic Trainer in Newark, DE
• Providers in Newark, DE by specialty
• Athletic Trainer in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2019; 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.