Nicholas Martin Wiegand, ATC, LAT

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

2017026211 Issued in MO

Practice address

600 Campus Dr
Wentzville, MO 63385-3433

Phone

(636) 327-3876

NPI assigned

Jun 25, 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": "1561420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684195200000",
    "number": "1326609934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11111 WHISPERING OAKS DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631365826",
            "telephone_number": "314-479-0628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 CAMPUS DR",
            "city": "WENTZVILLE",
            "state": "MO",
            "postal_code": "633853433",
            "telephone_number": "636-327-3876"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1832 Wentzville Pkwy",
            "address_purpose": "LOCATION",
            "city": "Wentzville",
            "state": "MO",
            "postal_code": "633853817",
            "country_code": "US",
            "telephone_number": "636-327-7110",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "790 N Highway 67 St",
            "address_purpose": "LOCATION",
            "city": "Florissant",
            "state": "MO",
            "postal_code": "630315108",
            "country_code": "US",
            "telephone_number": "314-972-1442",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WIEGAND",
        "first_name": "NICHOLAS",
        "middle_name": "MARTIN",
        "credential": "ATC, LAT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-25",
        "last_updated": "2023-05-16",
        "certification_date": "2023-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MO",
            "license": "2017026211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kevin Lynn White Jr.
• Sarah Emily Whittaker, MD
• Jennifer Lynn Whitter, LCSW
• Cerrisa Patrice Whittier-Lewis, BSN
• Alison Wickenheiser, PT
• Karen Marie Wiethuchter, MA, LPC
• Kacie-Lynn Wigger
• Amy Christeen Willard, PLPC
• Lori D Willard
• Amy Willbanks, NP

• Athletic Trainer in Wentzville, MO
• Providers in Wentzville, MO by specialty
• Athletic Trainer in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2023; 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.