Individual provider Active NPI

William Robert Geasa Jr., ATC

  • Athletic Trainer
  • Lakeland, FL
National Provider Identifier
1487618989
Registry record updated Jul 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
AL5250 Issued in FL
Practice address
1000 Longfellow Blvd
Lakeland, FL 33801-6034
Phone
(815) 530-2173
NPI assigned
Apr 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2024

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 AL5250 FL Primary

Addresses

Primary practice location

1000 Longfellow Blvd
Lakeland, FL 33801-6034

Mailing address

3442 Hilson Dr
Lakeland, FL 33812-4563
Phone (815) 530-2173

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
AL5250FLMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1144886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721865600000",
    "number": "1487618989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3442 HILSON DR",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338124563",
            "telephone_number": "815-530-2173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 LONGFELLOW BLVD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338016034",
            "telephone_number": "815-530-2173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEASA",
        "first_name": "WILLIAM",
        "middle_name": "ROBERT",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-13",
        "last_updated": "2024-07-25",
        "certification_date": "2024-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "FL",
            "license": "AL5250",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2024; 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.