Dalten Tyler Simnitch, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

2601002567 Issued in MI

Practice address

4100 Lake Dr SE Ste 300
Grand Rapids, MI 49546-8292

Phone

(616) 267-8860

NPI assigned

Jan 24, 2019

Sex

Male

Sole proprietor

No

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": "1548288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706832000000",
    "number": "1295299279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3941 BRENTON CT SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495088948",
            "telephone_number": "989-415-2957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 LAKE DR SE STE 300",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495468292",
            "telephone_number": "616-267-8860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMNITCH",
        "first_name": "DALTEN",
        "middle_name": "TYLER",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-01-24",
        "last_updated": "2024-02-02",
        "certification_date": "2024-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MI",
            "license": "2601002567",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Simmons
• Theresa Lyn Simmons
• Whisper Jean Simmons
• Jill Simms
• Nancy Debra Simms, MD
• Jennifer Simon, O.D.
• Juhanna Simon
• Juliana Haley Simon, MD
• Katie Michelle Simon, PA-C
• Nicole Elizabeth Simon, PA-C

• Athletic Trainer in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Athletic Trainer in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2024; 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.