Active NPI
Shane Winkenwader, ATC
- Athletic Trainer
- West Fargo, ND
National Provider Identifier
1427461706
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- Practice address
- 628 23Rd St E Apt B
West Fargo, ND 58078-2396 - Phone
- (701) 355-6483
- NPI assigned
- Jun 4, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | ND | Primary |
Addresses
Primary practice location
628 23Rd St E Apt B
West Fargo, ND 58078-2396
Mailing address
628 23Rd St E Apt B
West Fargo, ND 58078-2396
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": "1401840000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1401840000000",
"number": "1427461706",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "628 23RD ST E APT B",
"city": "WEST FARGO",
"state": "ND",
"postal_code": "580782396"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "628 23RD ST E APT B",
"city": "WEST FARGO",
"state": "ND",
"postal_code": "580782396",
"telephone_number": "701-355-6483"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WINKENWADER",
"first_name": "SHANE",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-06-04",
"last_updated": "2014-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "ND",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Fargo, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.