Kristen Henderson Laseta, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

949 Issued in SC

Practice address

4060 Wildcat Blvd
Charleston, SC 29414-5851

Phone

(843) 573-1201

NPI assigned

Jun 22, 2017

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": "1498089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498089600000",
    "number": "1326568197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "507 STINSON DR APT A6",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294076239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4060 WILDCAT BLVD",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294145851",
            "telephone_number": "843-573-1201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LASETA",
        "first_name": "KRISTEN",
        "middle_name": "HENDERSON",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-22",
        "last_updated": "2017-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "SC",
            "license": "949",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heidi Larson
• Richard Sigurd Larson III, DNP
• Mark Griffith Larue, DMD
• Mary Catherine Lasater
• Elizabeth Claire Lascala, PHARMD
• Christopher John Lashley, D.O.
• Deana Kay Lashley, D.O.
• Matthew C Laska
• Kerry Scott Lassiter, PH.D.
• Ward Lassoe, LPCI

• Athletic Trainer in Charleston, SC
• Providers in Charleston, SC by specialty
• Athletic Trainer in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2017; 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.