Mattison Mary Nicole Lagers, AT, PTA

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

883 Issued in OK

Practice address

2488 E 81St St Ste 290
Tulsa, OK 74137-4265

Phone

(918) 494-2665

Fax

(918) 927-3193

NPI assigned

Jun 9, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Mattison Mary Nicole Weber Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1591660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650240000000",
    "number": "1538784277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2488 E 81ST ST STE 290",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741374265",
            "telephone_number": "918-927-3226",
            "fax_number": "918-927-3193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2488 E 81ST ST STE 290",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741374265",
            "telephone_number": "918-494-2665",
            "fax_number": "918-927-3193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAGERS",
        "first_name": "MATTISON",
        "middle_name": "MARY NICOLE",
        "credential": "AT, PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-09",
        "last_updated": "2022-04-18",
        "certification_date": "2022-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "OK",
            "license": "2836",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "OK",
            "license": "883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MATTISON",
            "last_name": "WEBER",
            "middle_name": "MARY NICOLE",
            "credential": "AT, PTA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Cheryl C. Lafortune, M.A, C.C.C., SLP
• Emelia Tate Lafortune, AGACNP-BC
• Kathryn Anne Lafortune, J.D., PH.D.
• Dawn Marie Lafromboise, MD
• Jill Manahan Lagaso, M.D.
• Shannon Kay Lagers
• Faith Gabrielle Lagge
• Whitney Leighann Lahann
• Emma Lynn Lahmeyer
• Valerie Lahmeyer

• All providers in Tulsa, OK
• Athletic Trainer in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2022; 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.