Individual provider Active NPI

James David Pletsch, ATC

  • Athletic Trainer
  • Fayetteville, AR
National Provider Identifier
1366016776
Registry record updated May 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
Practice address
1748 N Whistling Straits Ave Apt 301
Fayetteville, AR 72704-6686
Phone
(217) 622-9456
NPI assigned
May 19, 2021
Last updated
May 19, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X NU Primary

Addresses

Primary practice location

1748 N Whistling Straits Ave Apt 301
Fayetteville, AR 72704-6686

Mailing address

1748 N Whistling Straits Ave Apt 301
Fayetteville, AR 72704-6686
Phone (217) 622-9456

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL FAYETTEVILLE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1621382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621382400000",
    "number": "1366016776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1748 N WHISTLING STRAITS AVE APT 301",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727046686",
            "telephone_number": "217-622-9456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1748 N WHISTLING STRAITS AVE APT 301",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727046686",
            "telephone_number": "217-622-9456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLETSCH",
        "first_name": "JAMES",
        "middle_name": "DAVID",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-19",
        "last_updated": "2021-05-19",
        "certification_date": "2021-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "FAYETTEVILLE",
            "affiliation": "N",
            "address_1": "1748 N Whistling Straits Ave Apt 301",
            "city": "Fayetteville",
            "state": "AR",
            "country_code": "US",
            "postal_code": "727046686",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fayetteville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2021; 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.