Individual provider Active NPI

Tessa Marie Laska, MAT

  • Athletic Trainer
  • Terre Haute, IN
National Provider Identifier
1952176026
Registry record updated Jan 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
36003909A Issued in IN
Practice address
567 N 5TH St
Terre Haute, IN 47809-4505
Phone
(651) 329-3743
NPI assigned
Nov 20, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2025

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 36003909A IN Primary

Addresses

Primary practice location

567 N 5TH St
Terre Haute, IN 47809-4505

Mailing address

332 6TH Ave N
South Saint Paul, MN 55075-2044
Phone (651) 329-3743

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
36003909AINMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1700438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736726400000",
    "number": "1952176026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "332 6TH AVE N",
            "city": "SOUTH SAINT PAUL",
            "state": "MN",
            "postal_code": "550752044",
            "telephone_number": "651-329-3743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "567 N 5TH ST",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478094505",
            "telephone_number": "651-329-3743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LASKA",
        "first_name": "TESSA",
        "middle_name": "MARIE",
        "credential": "MAT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-20",
        "last_updated": "2025-01-13",
        "certification_date": "2025-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IN",
            "license": "36003909A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Terre Haute, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2025; 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.