Sara J Gergely, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

36001261A Issued in IN

Practice address

3001 S Creasy LN Ste 100a
Lafayette, IN 47905

Phone

(765) 420-5800

NPI assigned

Mar 24, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Miss Sara J McKinley 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": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551052800000",
    "number": "1639139769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001 S CREASY LN STE 100A",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479055206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 S CREASY LN STE 100A",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "47905",
            "telephone_number": "765-420-5800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3001 S Creasy Ln Ste 100A",
            "address_purpose": "LOCATION",
            "city": "Lafayette",
            "state": "IN",
            "postal_code": "47905",
            "country_code": "US",
            "telephone_number": "765-420-5800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GERGELY",
        "first_name": "SARA",
        "middle_name": "J",
        "name_prefix": "Mrs.",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-24",
        "last_updated": "2019-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IN",
            "license": "36001261A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PROVIDER NUMBER",
            "identifier": "000000197905",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SARA",
            "last_name": "MCKINLEY",
            "middle_name": "J",
            "prefix": "MISS",
            "credential": "ATC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Giovanna A Giannico, MD
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• Athletic Trainer in Lafayette, IN
• Providers in Lafayette, IN by specialty
• Athletic Trainer in Indiana

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