Individual provider Active NPI

Max Whitsell

  • Athletic Trainer
  • Hammond, LA
National Provider Identifier
1932641404
Registry record updated Nov 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
ATH.200384 Issued in LA
Practice address
800 Galloway Dr
Hammond, LA 70402-0001
Phone
(985) 549-5401
NPI assigned
Nov 15, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 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 ATH.200384 LA Primary

Addresses

Primary practice location

800 Galloway Dr
Hammond, LA 70402-0001

Mailing address

Southeastern Louisiana University Athletics
Slu 10309
Hammond, LA 70402-0001

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
ATH.200384LAMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1479168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479168000000",
    "number": "1932641404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "SOUTHEASTERN LOUISIANA UNIVERSITY ATHLETICS",
            "address_2": "SLU 10309",
            "city": "HAMMOND",
            "state": "LA",
            "postal_code": "704020001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 GALLOWAY DR",
            "city": "HAMMOND",
            "state": "LA",
            "postal_code": "704020001",
            "telephone_number": "985-549-5401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITSELL",
        "first_name": "MAX",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-11-15",
        "last_updated": "2016-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "LA",
            "license": "ATH.200384",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hammond, LA

Sources for this page

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