Sean Patrick Clancy, LAT, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

36002954A Issued in IN

Practice address

2500 West Bethel Ave
Muncie, IN 47304

Phone

(317) 694-3925

NPI assigned

Feb 3, 2015

Last updated

Jul 3, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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": "1422921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719964800000",
    "number": "1104216712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8954 GLASS CHIMNEY LN",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460379438",
            "telephone_number": "317-694-3925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 WEST BETHEL AVE",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "47304",
            "telephone_number": "317-694-3925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLANCY",
        "first_name": "SEAN",
        "middle_name": "PATRICK",
        "credential": "LAT, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-02-03",
        "last_updated": "2024-07-03",
        "certification_date": "2024-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IN",
            "license": "36002954A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karen Cicotte, PT
• Ryan Dennis Cieply, MD
• Cio Medical Equipment, LLC
• City of Muncie
• City Optical Co., Inc. (Dr Tavel Family Eye Care)
• Andrew Clark, LMHC
• Bruce Brandon Clark
• Caitlyn Clark, RBT
• Carla Gaff Clark, EDD, HSPP
• Jordyn Clark

• Athletic Trainer in Muncie, IN
• Providers in Muncie, IN by specialty
• Athletic Trainer in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 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.