Individual provider Active NPI

Michael J O'Larey, ATC

  • Athletic Trainer
  • Las Cruces, NM
National Provider Identifier
1013050012
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
53 Issued in NM
Practice address
MSC 3Fac New Mexico State University
P P Box 30001
Las Cruces, NM 88003-8001
Phone
(505) 646-1526
Fax
(505) 646-3435
NPI assigned
Feb 15, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 53 NM Primary

Addresses

Primary practice location

MSC 3Fac New Mexico State University
P P Box 30001
Las Cruces, NM 88003-8001

Mailing address

3823 Lamanite CT
Las Cruces, NM 88012-7919
Phone (505) 646-1526

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

LicenseStateTypeSpecialty
53NMMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1013050012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3823 LAMANITE CT",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880127919",
            "telephone_number": "505-646-1526",
            "fax_number": "505-646-3435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MSC 3FAC NEW MEXICO STATE UNIVERSITY",
            "address_2": "P P BOX 30001",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880038001",
            "telephone_number": "505-646-1526",
            "fax_number": "505-646-3435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'LAREY",
        "first_name": "MICHAEL",
        "middle_name": "J",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NM",
            "license": "53",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Cruces, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.