Simon E Waguespack

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

Practice address

Southeastern Louisiana University
Hammond, LA 70402-0001

Phone

(800) 222-7358

NPI assigned

Mar 14, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1552521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552521600000",
    "number": "1356800957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29781 MACON DR",
            "city": "ALBANY",
            "state": "LA",
            "postal_code": "707113511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "SOUTHEASTERN LOUISIANA UNIVERSITY",
            "city": "HAMMOND",
            "state": "LA",
            "postal_code": "704020001",
            "telephone_number": "800-222-7358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGUESPACK",
        "first_name": "SIMON",
        "middle_name": "E",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-14",
        "last_updated": "2019-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Athletic Trainer in Hammond, LA
• Providers in Hammond, LA by specialty
• Athletic Trainer in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 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.