Active NPI
Daniel Carlysle Maclea IV, ATC
- Athletic Trainer
- Wesley Chapel, FL
National Provider Identifier
1366607186
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 1208
- Practice address
- 2600 Bruce B Downs Blvd
Wesley Chapel, FL 33544-9207 - Phone
- (615) 775-0055
- NPI assigned
- Jul 21, 2008
- Last updated
- Jul 22, 2014
- Sex
- Male
- Sole proprietor
- Yes
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 | 1208 | TN | Primary |
Addresses
Primary practice location
2600 Bruce B Downs Blvd
Wesley Chapel, FL 33544-9207
Mailing address
2600 Bruce B Downs Blvd
Wesley Chapel, FL 33544-9207
Phone (615) 775-0055
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1208 | TN | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1216598400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1405987200000",
"number": "1366607186",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2600 BRUCE B DOWNS BLVD",
"city": "WESLEY CHAPEL",
"state": "FL",
"postal_code": "335449207",
"telephone_number": "615-775-0055"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2600 BRUCE B DOWNS BLVD",
"city": "WESLEY CHAPEL",
"state": "FL",
"postal_code": "335449207",
"telephone_number": "615-775-0055"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACLEA",
"first_name": "DANIEL",
"middle_name": "CARLYSLE",
"name_prefix": "Mr.",
"name_suffix": "IV",
"credential": "ATC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-07-21",
"last_updated": "2014-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "TN",
"license": "1208",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wesley Chapel, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.