Active NPI
Amanda G. Wacasey
- Athletic Trainer
- Fort Worth, TX
National Provider Identifier
1336620947
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- Practice address
- 1201 Wesleyan St
Fort Worth, TX 76105-1536 - Phone
- (817) 629-8097
- NPI assigned
- Aug 22, 2018
- 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 | Primary |
Addresses
Primary practice location
1201 Wesleyan St
Fort Worth, TX 76105-1536
Mailing address
1201 Wesleyan St
Fort Worth, TX 76105-1536
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0000 | Other | NONE |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1534896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1534896000000",
"number": "1336620947",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1201 WESLEYAN ST",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761051536"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1201 WESLEYAN ST",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761051536",
"telephone_number": "817-629-8097"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WACASEY",
"first_name": "AMANDA",
"middle_name": "G.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-08-22",
"last_updated": "2018-08-22",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NONE",
"identifier": "0000",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Fort Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.