Active NPI
Maryellen Hole
- Athletic Trainer
- Prairie View, TX
National Provider Identifier
1841825239
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AT5720
- Practice address
- 1600 Stadium Drive
Prairie View, TX 77446 - Phone
- (936) 261-3965
- NPI assigned
- Mar 6, 2020
- Sex
- Female
- Sole proprietor
- No
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 | AT5720 | TX | Primary |
Addresses
Primary practice location
1600 Stadium Drive
Prairie View, TX 77446
Mailing address
PO Box 519 - Ms 1500
Prairie View, TX 77446
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 |
|---|---|---|---|
| AT5720 | TX | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1583452800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1583452800000",
"number": "1841825239",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 519 - MS 1500",
"city": "PRAIRIE VIEW",
"state": "TX",
"postal_code": "77446"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1600 STADIUM DRIVE",
"city": "PRAIRIE VIEW",
"state": "TX",
"postal_code": "77446",
"telephone_number": "936-261-3965"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLE",
"first_name": "MARYELLEN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-03-06",
"last_updated": "2020-03-06",
"certification_date": "2020-03-06",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "TX",
"license": "AT5720",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Prairie View, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 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.