Stefanie McMullen-Hamilton, LAT

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AT2500 Issued in TX

Practice address

927 Arp Dr
Troup, TX 75789-2907

Phone

(903) 842-4618

NPI assigned

May 4, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Stefanie McMullen 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": "1588550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588550400000",
    "number": "1982225652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10859 FM 2138 N",
            "city": "JACKSONVILLE",
            "state": "TX",
            "postal_code": "757668835",
            "telephone_number": "903-372-9318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "927 ARP DR",
            "city": "TROUP",
            "state": "TX",
            "postal_code": "757892907",
            "telephone_number": "903-842-4618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMULLEN-HAMILTON",
        "first_name": "STEFANIE",
        "name_prefix": "Mrs.",
        "credential": "LAT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-04",
        "last_updated": "2020-05-04",
        "certification_date": "2020-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "TX",
            "license": "AT2500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEFANIE",
            "last_name": "MCMULLEN",
            "credential": "LAT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• All providers in Troup, TX
• Athletic Trainer in Texas

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