Active NPI
Sean Russell Wasshausen, MA, LAT, ATC, CSCS
- Athletic Trainer
- Afton, WY
National Provider Identifier
1326408279
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 65
- Practice address
- 445 W Swift Creek LN
Afton, WY 83110-8004 - Phone
- (307) 248-0233
- NPI assigned
- Mar 3, 2016
- Last updated
- Mar 20, 2019
- Sex
- Male
- 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 | 65 | WY | Primary |
Addresses
Primary practice location
445 W Swift Creek LN
Afton, WY 83110-8004
Mailing address
446 Rounds Ave
New Richmond, WI 54017-2041
Phone (715) 716-6914
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 Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 65 | WY | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1456963200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1553040000000",
"number": "1326408279",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "446 ROUNDS AVE",
"city": "NEW RICHMOND",
"state": "WI",
"postal_code": "540172041",
"telephone_number": "715-716-6914"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "445 W SWIFT CREEK LN",
"city": "AFTON",
"state": "WY",
"postal_code": "831108004",
"telephone_number": "307-248-0233"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WASSHAUSEN",
"first_name": "SEAN",
"middle_name": "RUSSELL",
"credential": "MA, LAT, ATC, CSCS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-03-03",
"last_updated": "2019-03-20",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "WY",
"license": "65",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Afton, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 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.