Individual provider Active NPI

Courtney Upshaw, ATC, LAT

  • Athletic Trainer
  • Las Vegas, NV
National Provider Identifier
1346891553
Registry record updated Sep 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
0506533 Issued in NV
Practice address
4980 W Sahara Ave Ste 260
Las Vegas, NV 89146-3435
Phone
(610) 223-5944
NPI assigned
Sep 28, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 0506533 NV Primary

Addresses

Primary practice location

4980 W Sahara Ave Ste 260
Las Vegas, NV 89146-3435

Mailing address

1251 S Cimarron Rd Apt 29
Las Vegas, NV 89117-1394
Phone (864) 509-2055

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

State licenses

LicenseStateTypeSpecialty
0506533NVMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1569628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569628800000",
    "number": "1346891553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1251 S CIMARRON RD APT 29",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891171394",
            "telephone_number": "864-509-2055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4980 W SAHARA AVE STE 260",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891463435",
            "telephone_number": "610-223-5944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UPSHAW",
        "first_name": "COURTNEY",
        "credential": "ATC, LAT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-28",
        "last_updated": "2019-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NV",
            "license": "0506533",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 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.

Verify at the official NPI Registry.