Active NPI
Ryan Patrick Wantz, A.T.C
- Athletic Trainer
- Ridley Park, PA
National Provider Identifier
1003819558
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- RT003251
- Practice address
- 1 S Stewart Ave
Ridley Park, PA 19078-1002 - Phone
- (610) 591-1832
- NPI assigned
- May 28, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | RT003251 | PA | Primary |
Addresses
Primary practice location
1 S Stewart Ave
Ridley Park, PA 19078-1002
Mailing address
PO Box 16858
Philadelphia, PA 19142-0858
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
| License | State | Type | Specialty |
|---|---|---|---|
| RT003251 | PA | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1117238400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1437091200000",
"number": "1003819558",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 16858",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191420858"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 S STEWART AVE",
"city": "RIDLEY PARK",
"state": "PA",
"postal_code": "190781002",
"telephone_number": "610-591-1832"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WANTZ",
"first_name": "RYAN",
"middle_name": "PATRICK",
"name_prefix": "Mr.",
"credential": "A.T.C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-05-28",
"last_updated": "2015-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "PA",
"license": "RT003251",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ridley Park, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.