Active NPI
Timothy Kreidt, ATC, L.
- Athletic Trainer
- Dickinson, ND
National Provider Identifier
1215550249
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 194-17
- Practice address
- 291 Campus Dr
Dickinson, ND 58601-4853 - Phone
- (701) 483-2184
- NPI assigned
- May 26, 2020
- 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 | 194-17 | ND | Primary |
Addresses
Primary practice location
291 Campus Dr
Dickinson, ND 58601-4853
Mailing address
10440 25TH St SW
Dickinson, ND 58601-8338
Phone (701) 290-2788
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 |
|---|---|---|---|
| 194-17 | ND | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1590451200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1590451200000",
"number": "1215550249",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10440 25TH ST SW",
"city": "DICKINSON",
"state": "ND",
"postal_code": "586018338",
"telephone_number": "701-290-2788"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "291 CAMPUS DR",
"city": "DICKINSON",
"state": "ND",
"postal_code": "586014853",
"telephone_number": "701-483-2184"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KREIDT",
"first_name": "TIMOTHY",
"credential": "ATC, L.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-05-26",
"last_updated": "2020-05-26",
"certification_date": "2020-05-26",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "ND",
"license": "194-17",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dickinson, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 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.