Active NPI
Luis Angel Hernandez, LAT , ATC
- Athletic Trainer
- Wichita, KS
National Provider Identifier
1073228359
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 24-01653
- Practice address
- 3100 W McCormick Ave
Wichita, KS 67213 - Phone
- (785) 633-7507
- NPI assigned
- Jan 20, 2023
- 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 | 24-01653 | KS | Primary |
Addresses
Primary practice location
3100 W McCormick Ave
Wichita, KS 67213
Mailing address
2614 N Battin St
Wichita, KS 67220
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 |
|---|---|---|---|
| 24-01653 | KS | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1674172800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1674345600000",
"number": "1073228359",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2614 N BATTIN ST",
"city": "WICHITA",
"state": "KS",
"postal_code": "67220"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3100 W MCCORMICK AVE",
"city": "WICHITA",
"state": "KS",
"postal_code": "67213",
"telephone_number": "785-633-7507"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERNANDEZ",
"first_name": "LUIS",
"middle_name": "ANGEL",
"name_prefix": "Mr.",
"credential": "LAT , ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-01-20",
"last_updated": "2023-01-22",
"certification_date": "2023-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "KS",
"license": "24-01653",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wichita, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.