Taylor Witzel, LAT, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

079137 Issued in IA

Practice address

450 Laurel Street
Des Moines, IA 50314

Phone

(515) 323-6485

NPI assigned

Aug 28, 2015

Sex

Male

Sole proprietor

Yes

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

State licenses

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

{
    "created_epoch": "1440720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440720000000",
    "number": "1083081715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1262 OFFICE PARK RD",
            "address_2": "APARTMENT 5",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502652494",
            "telephone_number": "712-221-1870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 LAUREL STREET",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "50314",
            "telephone_number": "515-323-6485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITZEL",
        "first_name": "TAYLOR",
        "credential": "LAT, ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-08-28",
        "last_updated": "2015-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IA",
            "license": "079137",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wise Heart, LLC
• Michael C Witte, DO
• Robyn Jeanne Witte, RN
• Jason B Wittmer, MD
• Alexander Michael Wittry, MD
• Morgan Louise Reis Wohlgemuth
• Mark Douglas Woiwood, MD
• Joseph Wojcik, DO
• Jacob Scott Wolf, D.O.
• Abigail Susan Wolfe, LMSW

• Athletic Trainer in Des Moines, IA
• Providers in Des Moines, IA by specialty
• Athletic Trainer in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 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.

Verify at the official NPI Registry.