Shayla Alyson Vangurp, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

2000033529 Issued in NY

Practice address

630 Moriches Middle Island Rd
Moriches, NY 11955-1506

Phone

(631) 874-5505

NPI assigned

Aug 7, 2018

Last updated

Aug 7, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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": "1533600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533600000000",
    "number": "1316426745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 RAYNOR RD",
            "city": "RIDGE",
            "state": "NY",
            "postal_code": "119611900",
            "telephone_number": "631-258-2384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 MORICHES MIDDLE ISLAND RD",
            "city": "MORICHES",
            "state": "NY",
            "postal_code": "119551506",
            "telephone_number": "631-874-5505"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "630 Mastic Rd Ste 4",
            "address_purpose": "LOCATION",
            "city": "Mastic Beach",
            "state": "NY",
            "postal_code": "119511020",
            "country_code": "US",
            "telephone_number": "631-874-4710",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "240 Mastic Beach Rd",
            "address_purpose": "LOCATION",
            "city": "Mastic Beach",
            "state": "NY",
            "postal_code": "119511028",
            "country_code": "US",
            "telephone_number": "631-874-1120",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VANGURP",
        "first_name": "SHAYLA",
        "middle_name": "ALYSON",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-07",
        "last_updated": "2018-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NY",
            "license": "2000033529",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erika Steil, LMHC, CASAC
• Debra Stetler
• Christina Storm-Colantuono
• Sharon Elizabeth Sullivan, PT, MS
• Kafeel Syed
• We Provide and Care
• Franziska Winkler Desalvo, M.S.

• Athletic Trainer in Moriches, NY
• Providers in Moriches, 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 Aug 7, 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.

Verify at the official NPI Registry.