Active NPI
Lucas Dwayne Dargo, ATC
- Athletic Trainer
- Muncie, IN
National Provider Identifier
1730527706
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- Practice address
- 4121 W Pickell St
Muncie, IN 47303-9344 - Phone
- (765) 716-9272
- NPI assigned
- Jun 11, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Health Educator | 174H00000X | 10067876 | IN | |
| Athletic Trainer | 2255A2300X | Primary |
Addresses
Primary practice location
4121 W Pickell St
Muncie, IN 47303-9344
Mailing address
4121 W Pickell St
Muncie, IN 47303-9344
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
| License | State | Type | Specialty |
|---|---|---|---|
| 10067876 | IN | MD | Health Educator |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1370908800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1370908800000",
"number": "1730527706",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4121 W PICKELL ST",
"city": "MUNCIE",
"state": "IN",
"postal_code": "473039344"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4121 W PICKELL ST",
"city": "MUNCIE",
"state": "IN",
"postal_code": "473039344",
"telephone_number": "765-716-9272"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DARGO",
"first_name": "LUCAS",
"middle_name": "DWAYNE",
"name_prefix": "Mr.",
"credential": "ATC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-06-11",
"last_updated": "2013-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "174H00000X",
"taxonomy_group": "",
"desc": "Health Educator",
"state": "IN",
"license": "10067876",
"primary": false
},
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Muncie, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.