Individual provider Active NPI

Emily K Gantt, MS, LAT, ATC

  • Athletic Trainer
  • Las Vegas, NV
National Provider Identifier
1790496701
Registry record updated Dec 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
0506703 Issued in NV
Practice address
11845 Principi CT
Las Vegas, NV 89183-5545
Phone
(805) 345-5052
NPI assigned
Dec 9, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 9, 2022

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 0506703 NV Primary

Addresses

Primary practice location

11845 Principi CT
Las Vegas, NV 89183-5545

Mailing address

4980 W Sahara Ave Ste 260
Las Vegas, NV 89146-3435

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 Science

State licenses

LicenseStateTypeSpecialty
0506703NVMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1670544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670544000000",
    "number": "1790496701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4980 W SAHARA AVE STE 260",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891463435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11845 PRINCIPI CT",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891835545",
            "telephone_number": "805-345-5052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANTT",
        "first_name": "EMILY",
        "middle_name": "K",
        "name_prefix": "Ms.",
        "credential": "MS, LAT, ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-12-09",
        "last_updated": "2022-12-09",
        "certification_date": "2022-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NV",
            "license": "0506703",
            "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 Dec 9, 2022; 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.