Individual provider Active NPI

Shayla Joi Veasley, MS, ATC

  • Athletic Trainer
  • Long Island City, NY
National Provider Identifier
1871946798
Registry record updated Jul 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
003015-1 Issued in NY
Practice address
4436 Vernon Blvd
Long Island City, NY 11101-7006
Phone
(718) 707-4241
NPI assigned
Jul 15, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2016

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 003015-1 NY Primary

Addresses

Primary practice location

4436 Vernon Blvd
Long Island City, NY 11101-7006

Mailing address

4436 Vernon Blvd
Long Island City, NY 11101-7006
Phone (718) 707-4241

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
003015-1NYMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1468540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468540800000",
    "number": "1871946798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4436 VERNON BLVD",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111017006",
            "telephone_number": "718-707-4241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4436 VERNON BLVD",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111017006",
            "telephone_number": "718-707-4241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VEASLEY",
        "first_name": "SHAYLA",
        "middle_name": "JOI",
        "credential": "MS, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-15",
        "last_updated": "2016-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NY",
            "license": "003015-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Island City, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2016; 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.