Individual provider Active NPI

Megan Wasiak, MS, LAT, ATC, CES

  • Athletic Trainer
  • Las Vegas, NV
National Provider Identifier
1023550555
Registry record updated Nov 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
0506420 Issued in NV
Practice address
3633 Fox Heather Dr
Las Vegas, NV 89129-7034
Phone
(702) 235-2363
NPI assigned
Nov 15, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 15, 2016

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 0506420 NV Primary

Addresses

Primary practice location

3633 Fox Heather Dr
Las Vegas, NV 89129-7034

Mailing address

3633 Fox Heather Dr
Las Vegas, NV 89129-7034

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
0506420NVMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1479168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479168000000",
    "number": "1023550555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3633 FOX HEATHER DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891297034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3633 FOX HEATHER DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891297034",
            "telephone_number": "702-235-2363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASIAK",
        "first_name": "MEGAN",
        "credential": "MS, LAT, ATC, CES",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-11-15",
        "last_updated": "2016-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NV",
            "license": "0506420",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2016; 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.