Individual provider Active NPI

Lucas Bianco, ATC, CSCS

  • Athletic Trainer
  • Las Vegas, NV
National Provider Identifier
1114348968
Registry record updated Dec 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
0506296 Issued in NV
Practice address
3601 Cambridge St Apt 149
Las Vegas, NV 89169-4010
Phone
(845) 728-4176
NPI assigned
Dec 20, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 20, 2013

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 0506296 NV Primary

Addresses

Primary practice location

3601 Cambridge St Apt 149
Las Vegas, NV 89169-4010

Mailing address

3601 Cambridge St Apt 149
Las Vegas, NV 89169-4010
Phone (845) 728-4176

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
0506296NVMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1387497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387497600000",
    "number": "1114348968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3601 CAMBRIDGE ST APT 149",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891694010",
            "telephone_number": "845-728-4176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 CAMBRIDGE ST APT 149",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891694010",
            "telephone_number": "845-728-4176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIANCO",
        "first_name": "LUCAS",
        "credential": "ATC, CSCS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-12-20",
        "last_updated": "2013-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NV",
            "license": "0506296",
            "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 Dec 20, 2013; 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.