Individual provider Active NPI

Mitchell Lawson, ATC

  • Athletic Trainer
  • Lees Summit, MO
National Provider Identifier
1659765394
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
2017026436 Issued in MO
Practice address
120 NE Saint Lukes Blvd Ste 200
Lees Summit, MO 64086-6011
Phone
(816) 246-4302
NPI assigned
Mar 19, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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 2017026436 MO Primary

Addresses

Primary practice location

120 NE Saint Lukes Blvd Ste 200
Lees Summit, MO 64086-6011

Mailing address

200 SW 21St Rd
Warrensburg, MO 64093-7560

Other practice location 1

200 SW 21st Rd
Warrensburg, MO 64093-7560
Phone (660) 429-2786

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
2017026436MOMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1426723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1659765394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 SW 21ST RD",
            "city": "WARRENSBURG",
            "state": "MO",
            "postal_code": "640937560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 NE SAINT LUKES BLVD STE 200",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640866011",
            "telephone_number": "816-246-4302"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 SW 21st Rd",
            "address_purpose": "LOCATION",
            "city": "Warrensburg",
            "state": "MO",
            "postal_code": "640937560",
            "country_code": "US",
            "telephone_number": "660-429-2786",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAWSON",
        "first_name": "MITCHELL",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-03-19",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MO",
            "license": "2017026436",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lees Summit, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.