Mikaela Ann Poorman, ATS

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

Practice address

Rec Hall , Burrowes Rd
University Park, PA 16802

Phone

(814) 865-5284

NPI assigned

Apr 2, 2018

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1522627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599177600000",
    "number": "1962908780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2267 MUNSTER RD",
            "city": "LILLY",
            "state": "PA",
            "postal_code": "159386201",
            "telephone_number": "814-381-4646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "REC HALL , BURROWES RD",
            "city": "UNIVERSITY PARK",
            "state": "PA",
            "postal_code": "16802",
            "telephone_number": "814-865-5284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POORMAN",
        "first_name": "MIKAELA",
        "middle_name": "ANN",
        "credential": "ATS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-02",
        "last_updated": "2020-09-04",
        "certification_date": "2020-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pennsylvania State University
• Emma Phillips
• Aaron Lee Pincus
• Jessica Marie Pisarcik, PA-C
• Leigh A Pitterle, RN
• Leslie A Purcell, CCC-A
• Brian Alan Rabian
• Madeline Elizabeth Radzwich, RN
• Dyani R. Ratchford, PA-C
• William J Ray, PHD

• Athletic Trainer in University Park, PA
• Providers in University Park, PA by specialty
• Athletic Trainer in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 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.

Verify at the official NPI Registry.