Abby Marie Miller, MPA ATC LAT

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

000904 Issued in IA

Practice address

1709 N Jefferson Way Ste 100
Indianola, IA 50125-1459

Phone

(515) 962-9272

Fax

(515) 962-9282

NPI assigned

Apr 19, 2016

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 names 1

• Miss Abby Marie Marshall Former name

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": "1461024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461024000000",
    "number": "1902250657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5401 SE 27TH ST",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503202756",
            "telephone_number": "641-521-2060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1709 N JEFFERSON WAY STE 100",
            "city": "INDIANOLA",
            "state": "IA",
            "postal_code": "501251459",
            "telephone_number": "515-962-9272",
            "fax_number": "515-962-9282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "ABBY",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "MPA ATC LAT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-19",
        "last_updated": "2016-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IA",
            "license": "000904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ABBY",
            "last_name": "MARSHALL",
            "middle_name": "MARIE",
            "prefix": "MISS",
            "credential": "ATC LAT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• All providers in Indianola, IA
• Athletic Trainer in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2016; 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.