Megan E Mezera, LAT, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

2349-39 Issued in WI

Practice address

105 E Lincoln Ave
Lancaster, WI 53813-2019

Phone

(608) 723-3100

NPI assigned

Jan 3, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Megan Leclair Former name

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": "1546473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730246400000",
    "number": "1255804068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "429 E CHERRY ST",
            "city": "LANCASTER",
            "state": "WI",
            "postal_code": "538131716",
            "telephone_number": "920-493-5632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 E LINCOLN AVE",
            "city": "LANCASTER",
            "state": "WI",
            "postal_code": "538132019",
            "telephone_number": "608-723-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEZERA",
        "first_name": "MEGAN",
        "middle_name": "E",
        "credential": "LAT, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-03",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "WI",
            "license": "2349-39",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MEGAN",
            "last_name": "LECLAIR",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Katherine Shanon McQuillan, APNP
• Heather M Meier
• Laurie J Meighan, APNP
• Abby Mergen
• Michael Francis Metz, PA-C
• Michelle Kane
• Natalie Miller, PT, DPT
• Kelly S Muench, PA-C
• Megan Mumm
• Leslie A Newhouse, PA

• Athletic Trainer in Lancaster, WI
• Providers in Lancaster, WI by specialty
• Athletic Trainer in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 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.