Active NPI
Tyler Weeda
- Athletic Trainer
- Lincoln, NE
National Provider Identifier
1073016275
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 583
- Practice address
- 1600 Court St
Lincoln, NE 68588-1098 - Phone
- (319) 361-8822
- NPI assigned
- Mar 14, 2018
- Sex
- Male
- Sole proprietor
- Yes
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 | 583 | NE | Primary |
Addresses
Primary practice location
1600 Court St
Lincoln, NE 68588-1098
Mailing address
2215 S 35TH St
Lincoln, NE 68506-6012
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 |
|---|---|---|---|
| 583 | NE | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1520985600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1520985600000",
"number": "1073016275",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2215 S 35TH ST",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685066012"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1600 COURT ST",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685881098",
"telephone_number": "319-361-8822"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEEDA",
"first_name": "TYLER",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-03-14",
"last_updated": "2018-03-14",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "NE",
"license": "583",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lincoln, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.