Shaun Waldron, ATC, LMT

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

001911 Issued in NY

Practice address

5496 E Taft Rd Ste C
North Syracuse, NY 13212-3784

Phone

(315) 251-3100

NPI assigned

Apr 4, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Syracuse Orthopedic Specialists, PLLC

  • Orthopaedic Surgery Physician
  • Syracuse, NY
  • NPI 1669410379
  NPD (past)
• Syracuse Orthopedic Specialists, PLLC

  • Durable Medical Equipment & Medical Supplies
  • North Syracuse, NY
  • NPI 1891033189
  NPD (past)

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

{
    "created_epoch": "1301875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460678400000",
    "number": "1306135009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5496 E TAFT RD STE C",
            "city": "NORTH SYRACUSE",
            "state": "NY",
            "postal_code": "132123784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5496 E TAFT RD STE C",
            "city": "NORTH SYRACUSE",
            "state": "NY",
            "postal_code": "132123784",
            "telephone_number": "315-251-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALDRON",
        "first_name": "SHAUN",
        "credential": "ATC, LMT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-04",
        "last_updated": "2016-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NY",
            "license": "001911",
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NY",
            "license": "024785",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sara Urciuoli, LMHC
• Toni Lynne Vadala, LCSW, LMSW
• Carrie Marie Vincent, PHYSICAL THERAPIST
• Gayle Lynn Vinette, RN
• Susan Wagner, NP
• Walgreen Co
• Walgreen Co
• Johnny Waters, MHC
• Amber Wayne, PHARMD
• Tracy Lynn Wendt, NP

• Athletic Trainer in North Syracuse, NY
• Providers in North Syracuse, NY by specialty
• Athletic Trainer in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2016; 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.