Individual provider Active NPI

Micaela Lozano, MAT, ATC, LAT, SCAT

  • Athletic Trainer
  • Greenville, SC
National Provider Identifier
1891077590
Registry record updated Sep 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
1265 Issued in SC
Practice address
3300 Poinsett Hwy
Greenville, SC 29613-0002
Phone
(864) 294-3535
NPI assigned
Sep 19, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 19, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 1265 SC Primary

Addresses

Primary practice location

3300 Poinsett Hwy
Greenville, SC 29613-0002

Mailing address

2721 Edinboro Dr
Arlington, TX 76012-5396
Phone (817) 277-0509

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

LicenseStateTypeSpecialty
1265SCMDAthletic Trainer

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1316390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316390400000",
    "number": "1891077590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2721 EDINBORO DR",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760125396",
            "telephone_number": "817-277-0509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 POINSETT HWY",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296130002",
            "telephone_number": "864-294-3535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOZANO",
        "first_name": "MICAELA",
        "credential": "MAT, ATC, LAT, SCAT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-19",
        "last_updated": "2011-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "SC",
            "license": "1265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2011; 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.