Zachary Allen Wisniewski, MAT, LAT, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

Practice address

32 Campus Dr
Missoula, MT 59812-0003

Phone

(406) 253-0211

NPI assigned

Jul 5, 2019

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1562284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690761600000",
    "number": "1053973479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2414 39TH ST APT 301",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598031171",
            "telephone_number": "907-319-4363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32 CAMPUS DR",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598120003",
            "telephone_number": "406-253-0211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISNIEWSKI",
        "first_name": "ZACHARY",
        "middle_name": "ALLEN",
        "credential": "MAT, LAT, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-05",
        "last_updated": "2023-07-31",
        "certification_date": "2023-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gavin Joseph Wisdom, MSW, LAC, SWLC
• Wisebridge Therapy, PLLC
• Brittany Dawn Wiseman
• Chalynne Marie Wisniewski, MAT, LAT, ATC
• Nadine M. Wisniewski, PH.D.
• Jason Patrick Wissinger, MD
• Grant Matthew Wiswell, MD, DDS
• Without Limits, Inc.
• Zackery W Witte, M.D.
• Carissa Marie Woelich, OD

• All providers in Missoula, MT
• Athletic Trainer in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2023; 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.