Individual provider Active NPI

Meghan Rose Pugh, DAT, LAT, ATC

  • Military Health Care Provider
  • Quantico, VA
National Provider Identifier
1093328775
Registry record updated Apr 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Military Health Care ProviderTaxonomy code 171000000X
Practice address
24164 Belleau Ave
Quantico, VA 22134-5106
Phone
(808) 294-1026
NPI assigned
Aug 24, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X AL6319 FL
Military Health Care Provider 171000000X Primary

Addresses

Primary practice location

24164 Belleau Ave
Quantico, VA 22134-5106

Mailing address

1202 S Washington St Apt 119
Alexandria, VA 22314-4496
Phone (808) 294-1026

Other practice location 1

3450 Hull Rd
Gainesville, FL 32607-4144
Phone (352) 273-7002

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
AL6319FLMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1598227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713225600000",
    "number": "1093328775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1202 S WASHINGTON ST APT 119",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223144496",
            "telephone_number": "808-294-1026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24164 BELLEAU AVE",
            "city": "QUANTICO",
            "state": "VA",
            "postal_code": "221345106",
            "telephone_number": "808-294-1026"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3450 Hull Rd",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "FL",
            "postal_code": "326074144",
            "country_code": "US",
            "telephone_number": "352-273-7002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PUGH",
        "first_name": "MEGHAN",
        "middle_name": "ROSE",
        "name_prefix": "Dr.",
        "credential": "DAT, LAT, ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-24",
        "last_updated": "2024-04-16",
        "certification_date": "2024-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "FL",
            "license": "AL6319",
            "primary": false
        },
        {
            "code": "171000000X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Quantico, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2024; 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.