Active NPI
Michael Wayne Hilliard, ATC
- Athletic Trainer
- Moorhead, MN
National Provider Identifier
1972019727
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 2826
- Practice address
- 649 17TH St S
Moorhead, MN 56560 - Phone
- (360) 751-9904
- NPI assigned
- Dec 15, 2017
- Sex
- Male
- 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 | 2826 | MN | Primary |
Addresses
Primary practice location
649 17TH St S
Moorhead, MN 56560
Mailing address
649 17TH St S
Moorhead, MN 56560
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1513296000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1520985600000",
"number": "1972019727",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "649 17TH ST S",
"city": "MOORHEAD",
"state": "MN",
"postal_code": "56560"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "649 17TH ST S",
"city": "MOORHEAD",
"state": "MN",
"postal_code": "56560",
"telephone_number": "360-751-9904"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HILLIARD",
"first_name": "MICHAEL",
"middle_name": "WAYNE",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-12-15",
"last_updated": "2018-03-14",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "MN",
"license": "2826",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Moorhead, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 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.