Active NPI
Mackenzie Adams, ATC, LAT
- Athletic Trainer
- Groesbeck, TX
National Provider Identifier
1972003374
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AT6279
- Practice address
- 1202 N Ellis St
Groesbeck, TX 76642-2111 - Phone
- (254) 729-4630
- Fax
- (254) 729-4630
- NPI assigned
- Feb 13, 2018
- Sex
- Female
- Sole proprietor
- Yes
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 | AT6279 | TX | Primary |
Addresses
Primary practice location
1202 N Ellis St
Groesbeck, TX 76642-2111
Mailing address
2500 Marketplace Dr Apt 224
Waco, TX 76711-2435
Phone (269) 221-4823
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 |
|---|---|---|---|
| AT6279 | TX | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1518480000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1518480000000",
"number": "1972003374",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2500 MARKETPLACE DR APT 224",
"city": "WACO",
"state": "TX",
"postal_code": "767112435",
"telephone_number": "269-221-4823"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1202 N ELLIS ST",
"city": "GROESBECK",
"state": "TX",
"postal_code": "766422111",
"telephone_number": "254-729-4630",
"fax_number": "254-729-4630"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ADAMS",
"first_name": "MACKENZIE",
"name_prefix": "Ms.",
"credential": "ATC, LAT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-02-13",
"last_updated": "2018-02-13",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "TX",
"license": "AT6279",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Groesbeck, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.