Mikayla Lynn Hogan

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

36003722A Issued in IN

Practice address

2101 E Coliseum Blvd
Fort Wayne, IN 46805-1445

Phone

(260) 481-6656

NPI assigned

Jul 13, 2021

Last updated

Apr 24, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 2

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": "1626134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682294400000",
    "number": "1790357440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5601 OLD DOVER BLVD APT 5",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468352816",
            "telephone_number": "920-538-6885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 E COLISEUM BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468051445",
            "telephone_number": "260-481-6656"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Campus Dr",
            "address_purpose": "LOCATION",
            "city": "Elkins",
            "state": "WV",
            "postal_code": "262413971",
            "country_code": "US",
            "telephone_number": "304-637-1900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOGAN",
        "first_name": "MIKAYLA",
        "middle_name": "LYNN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-13",
        "last_updated": "2023-04-24",
        "certification_date": "2023-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "WV",
            "license": null,
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IN",
            "license": "36003722A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mikayla.hogan@myovu.net",
            "affiliation": "N",
            "address_1": "100 Campus Dr",
            "city": "Elkins",
            "state": "WV",
            "country_code": "US",
            "postal_code": "262413971",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "mlhogan@pfw.edu",
            "affiliation": "N",
            "address_1": "2101 E Coliseum Blvd",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468051445",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Laura Mitchell Hoffman, LCSW
• Michaela Hoffman, LAT, ATC, CSCS
• Michelle A. Hoffman, MSSA, LSW
• Theresa K Hoffman, DO
• Thomas Joseph Hoffman, DDS
• Taylea Hogan, RBT
• Vanessa Michelle Hogan, LMHC, LCAC
• Isabelle Hogle
• Ana Hoglund
• James A Holb, RD,LD,CDE

• Athletic Trainer in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Athletic Trainer in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2023; 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.