Active NPI
Lacy L Gunn, MS, ATC
- Athletic Trainer
- Cortland, NY
National Provider Identifier
1639700057
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 002260-1
- Practice address
- Suny Cortland
Cortland, NY 13045 - Phone
- (607) 753-4787
- Fax
- (607) 753-5929
- NPI assigned
- Feb 4, 2020
- Sex
- Female
- Sole proprietor
- No
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 | 002260-1 | NY | Primary |
Addresses
Primary practice location
Suny Cortland
Cortland, NY 13045
Mailing address
4 Austin Rd
Tully, NY 13159-2409
Phone (607) 753-4787
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 120502180 | Other | BOARD OF CERTIFICATION | |
| 002260-1 | Other | NY | DEPARTMENT OF EDUCATION OFFICE OF THE PROFESSIONS |
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 002260-1 | NY | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1580774400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1580774400000",
"number": "1639700057",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4 AUSTIN RD",
"city": "TULLY",
"state": "NY",
"postal_code": "131592409",
"telephone_number": "607-753-4787",
"fax_number": "607-753-5959"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "SUNY CORTLAND",
"city": "CORTLAND",
"state": "NY",
"postal_code": "13045",
"telephone_number": "607-753-4787",
"fax_number": "607-753-5929"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUNN",
"first_name": "LACY",
"middle_name": "L",
"credential": "MS, ATC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-02-04",
"last_updated": "2020-02-04",
"certification_date": "2020-02-04",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "NY",
"license": "002260-1",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BOARD OF CERTIFICATION",
"identifier": "120502180",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEPARTMENT OF EDUCATION OFFICE OF THE PROFESSIONS",
"identifier": "002260-1",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cortland, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.