Daniel Wendell Diers, MPT, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AT0274 Issued in MS

Practice address

23 Mason St
Laurel, MS 39440-4437

Phone

(601) 399-0534

Fax

(601) 425-7585

NPI assigned

Mar 7, 2007

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

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": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1275663304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "92 MERCHANT CIR",
            "city": "ELLISVILLE",
            "state": "MS",
            "postal_code": "394378709",
            "telephone_number": "601-319-1518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 MASON ST",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394404437",
            "telephone_number": "601-399-0534",
            "fax_number": "601-425-7585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIERS",
        "first_name": "DANIEL",
        "middle_name": "WENDELL",
        "name_prefix": "Mr.",
        "credential": "MPT, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-07",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "PT3215",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MS",
            "license": "AT0274",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Athletic Trainer in Laurel, MS
• Providers in Laurel, MS by specialty
• Athletic Trainer in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.