Peter Michael Houdek, MS, LAT, ATC, CES

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

RT004946 Issued in PA

Practice address

205 W Allegheny Rd
Imperial, PA 15126-9770

Phone

(215) 380-2208

NPI assigned

Jan 13, 2016

Last updated

Sep 16, 2020By the provider in NPPES

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

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1452643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600214400000",
    "number": "1336505841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 JACOBS CT",
            "city": "CRANBERRY TWP",
            "state": "PA",
            "postal_code": "160663376",
            "telephone_number": "215-380-2208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 W ALLEGHENY RD",
            "city": "IMPERIAL",
            "state": "PA",
            "postal_code": "151269770",
            "telephone_number": "215-380-2208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOUDEK",
        "first_name": "PETER",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "MS, LAT, ATC, CES",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-01-13",
        "last_updated": "2020-09-16",
        "certification_date": "2020-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "PA",
            "license": "RT004946",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Graham, PT
• Heather Mangieri Nutrition, LLC
• Bradley W Heiple, D.O.
• Heritage Valley Medical Group, Inc (HVMG West Allegheny Healthcare)
• Adam Hernley, PHARMD
• Howard Irwin Counseling
• Imperial Chiropractic & Rehabilitation
• Alexis R Irwin, LMT
• Harley Jaggi
• Katherine Jeppesen

• Athletic Trainer in Imperial, PA
• Providers in Imperial, PA by specialty
• Athletic Trainer in Pennsylvania

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

Verify at the official NPI Registry.