Individual provider Active NPI

Michael Sepiol, ATC, LAT

  • Athletic Trainer
  • Las Vegas, NV
National Provider Identifier
1750932992
Registry record updated Sep 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
0506411 Issued in NV
Practice address
1350 Spruce Park Dr Ste 209
Las Vegas, NV 89135-1034
Phone
(708) 650-0167
NPI assigned
Sep 27, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 27, 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 0506411 NV Primary

Addresses

Primary practice location

1350 Spruce Park Dr Ste 209
Las Vegas, NV 89135-1034

Mailing address

1350 Spruce Park Dr Ste 209
Las Vegas, NV 89135-1034

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
0506411NVMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1569542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569542400000",
    "number": "1750932992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 SPRUCE PARK DR STE 209",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891351034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 SPRUCE PARK DR STE 209",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891351034",
            "telephone_number": "708-650-0167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEPIOL",
        "first_name": "MICHAEL",
        "credential": "ATC, LAT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-09-27",
        "last_updated": "2019-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NV",
            "license": "0506411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 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.