Wiltey Russell Kendle, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

Practice address

228 17TH Ave NW
Great Falls, MT 59404-1807

Phone

(406) 268-6223

NPI assigned

Jun 20, 2007

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

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

{
    "created_epoch": "1182297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1265637177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 WOODLAND ESTATES RD",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "594046405",
            "telephone_number": "406-453-9030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "228 17TH AVE NW",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "594041807",
            "telephone_number": "406-268-6223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENDLE",
        "first_name": "WILTEY",
        "middle_name": "RUSSELL",
        "name_prefix": "Mr.",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lora Ann Keller, COTA
• Christine M. Kelly, M.S., A.T.,C.
• Maria Kelly, NP-C
• Shawn C. Kelly, M.D.
• Kelsey Ashmore PLLC
• Kate A Kennedy, ND
• Sarah Roos Kenney, M.D.
• Bryce Kent, PHARMD
• Kephas Corporation
• Keri Kingland LMT LLC

• Athletic Trainer in Great Falls, MT
• Providers in Great Falls, MT by specialty
• Athletic Trainer in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.