Individual provider Active NPI

Megan L Santos, ATC

  • Athletic Trainer
  • Leesburg, VA
National Provider Identifier
1235777459
Registry record updated Dec 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
0126001540 Issued in VA
Practice address
415 Dry Mill Rd SW
Leesburg, VA 20175-3409
Phone
(571) 252-2010
NPI assigned
Dec 18, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2019

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 0126001540 VA Primary

Addresses

Primary practice location

415 Dry Mill Rd SW
Leesburg, VA 20175-3409

Mailing address

415 Dry Mill Rd SW
Leesburg, VA 20175-3409
Phone (571) 252-2010

Other identifiers 2

IdentifierTypeStateIssuer
0126001540OtherVACOMMONWEALTH OF VIRGINIA BOARD OF MEDICINE LICENSE
060802096OtherNATA BOC

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
0126001540VAMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1576627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576627200000",
    "number": "1235777459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 DRY MILL RD SW",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201753409",
            "telephone_number": "571-252-2010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 DRY MILL RD SW",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201753409",
            "telephone_number": "571-252-2010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTOS",
        "first_name": "MEGAN",
        "middle_name": "L",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-18",
        "last_updated": "2019-12-18",
        "certification_date": "2019-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "VA",
            "license": "0126001540",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMONWEALTH OF VIRGINIA BOARD OF MEDICINE LICENSE",
            "identifier": "0126001540",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATA BOC",
            "identifier": "060802096",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2019; 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.