Individual provider Active NPI

Lauralee Virginia Hatleli, MED, LAT, ATC, CEAS

  • Athletic Trainer
  • Indianapolis, IN
National Provider Identifier
1740670223
Registry record updated Aug 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
36002460A Issued in IN
Practice address
6428 Bower Dr
Indianapolis, IN 46241-1861
Phone
(217) 855-2757
NPI assigned
Feb 4, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 12, 2019

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 36002460A IN Primary

Addresses

Primary practice location

6428 Bower Dr
Indianapolis, IN 46241-1861

Mailing address

6428 Bower Dr
Indianapolis, IN 46241-1861
Phone (217) 855-2757

Other practice location 1

2800 Palmyra Rd
Hannibal, MO 63401-1940
Phone (573) 629-3223

Other names 1

  • Miss Lauralee Virginia Williams Former name

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 Education

State licenses

LicenseStateTypeSpecialty
36002460AINMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1423008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565568000000",
    "number": "1740670223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6428 BOWER DR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462411861",
            "telephone_number": "217-855-2757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6428 BOWER DR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462411861",
            "telephone_number": "217-855-2757"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2800 Palmyra Rd",
            "address_purpose": "LOCATION",
            "city": "Hannibal",
            "state": "MO",
            "postal_code": "634011940",
            "country_code": "US",
            "telephone_number": "573-629-3223",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HATLELI",
        "first_name": "LAURALEE",
        "middle_name": "VIRGINIA",
        "name_prefix": "Mrs.",
        "credential": "MED, LAT, ATC, CEAS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-02-04",
        "last_updated": "2019-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IN",
            "license": "36002460A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURALEE",
            "last_name": "WILLIAMS",
            "middle_name": "VIRGINIA",
            "prefix": "MISS",
            "credential": "MED, LAT, ATC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 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.