Shannon Rae Leghart, MAT, LAT, ATC ,BSAS

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

Practice address

46400 Lexington Village Way Ste 108
Lexington Park, MD 20653-5570

Phone

(301) 798-7020

NPI assigned

Feb 5, 2019

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1549324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584403200000",
    "number": "1760947758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6361 HELEN ST",
            "city": "SOUTH PARK",
            "state": "PA",
            "postal_code": "151299653",
            "telephone_number": "412-251-1070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "46400 LEXINGTON VILLAGE WAY STE 108",
            "city": "LEXINGTON PARK",
            "state": "MD",
            "postal_code": "206535570",
            "telephone_number": "301-798-7020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 University Plz",
            "address_purpose": "LOCATION",
            "city": "Youngstown",
            "state": "OH",
            "postal_code": "445550001",
            "country_code": "US",
            "telephone_number": "330-941-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEGHART",
        "first_name": "SHANNON",
        "middle_name": "RAE",
        "credential": "MAT, LAT, ATC ,BSAS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-05",
        "last_updated": "2020-03-17",
        "certification_date": "2020-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Athletic Trainer in Lexington Park, MD
• Providers in Lexington Park, MD by specialty
• Athletic Trainer in Maryland

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

Verify at the official NPI Registry.