Individual provider Active NPI

Michael James Schwartz, ATC, LAT, MBA

  • Athletic Trainer
  • Cedar Rapids, IA
National Provider Identifier
1104291970
Registry record updated Jan 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
087735 Issued in IA
Practice address
3235 Williams Pkwy SW
Cedar Rapids, IA 52404-1427
Phone
(319) 364-2311
NPI assigned
Dec 4, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2020

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 087735 IA Primary

Addresses

Primary practice location

3235 Williams Pkwy SW
Cedar Rapids, IA 52404-1427

Mailing address

4915 Montclair Dr NW
Cedar Rapids, IA 52405-2829
Phone (309) 299-5433

Other practice location 1

1205 Potter Dr
Colorado Springs, CO 80909-6908
Phone (719) 328-6703

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
Credentials
Master of Business Administration

State licenses

LicenseStateTypeSpecialty
087735IAMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Spanda Inc PastSince Dec 1, 2019 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1449187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579651200000",
    "number": "1104291970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4915 MONTCLAIR DR NW",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524052829",
            "telephone_number": "309-299-5433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3235 WILLIAMS PKWY SW",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524041427",
            "telephone_number": "319-364-2311"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1205 Potter Dr",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809096908",
            "country_code": "US",
            "telephone_number": "719-328-6703",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHWARTZ",
        "first_name": "MICHAEL",
        "middle_name": "JAMES",
        "credential": "ATC, LAT, MBA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-12-04",
        "last_updated": "2020-01-22",
        "certification_date": "2020-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IA",
            "license": "087735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Rapids, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2020; 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.