Active NPI
Alicia Lysiuk, LAT, ATC, MS
- Athletic Trainer
- Anderson, IN
National Provider Identifier
1285952382
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 36001004A
- Practice address
- 3125 S Scatterfield Rd Ste 210
Anderson, IN 46013-1804 - Phone
- (765) 298-4311
- Fax
- (765) 298-4312
- NPI assigned
- May 13, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 36001004A | IN | Primary |
Addresses
Primary practice location
3125 S Scatterfield Rd Ste 210
Anderson, IN 46013-1804
Mailing address
10752 Chestnut Heath CT
Noblesville, IN 46060-6117
Phone (317) 417-6217
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36001004A | IN | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1273708800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1537920000000",
"number": "1285952382",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10752 CHESTNUT HEATH CT",
"city": "NOBLESVILLE",
"state": "IN",
"postal_code": "460606117",
"telephone_number": "317-417-6217"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3125 S SCATTERFIELD RD STE 210",
"city": "ANDERSON",
"state": "IN",
"postal_code": "460131804",
"telephone_number": "765-298-4311",
"fax_number": "765-298-4312"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LYSIUK",
"first_name": "ALICIA",
"credential": "LAT, ATC, MS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-05-13",
"last_updated": "2018-09-26",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "IN",
"license": "36001004A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Anderson, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.