David John Dziedzicki, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

Practice address

Student Services Building RM 201
Terre Haute, IN 47809-0001

Phone

(812) 237-8232

NPI assigned

Aug 20, 2010

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

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

{
    "created_epoch": "1282262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282262400000",
    "number": "1447566013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1242 HERITAGE LN W",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478031397",
            "telephone_number": "216-904-6507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "STUDENT SERVICES BUILDING RM 201",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478090001",
            "telephone_number": "812-237-8232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DZIEDZICKI",
        "first_name": "DAVID",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-08-20",
        "last_updated": "2010-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Athletic Trainer in Terre Haute, IN
• Providers in Terre Haute, IN by specialty
• Athletic Trainer in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2010; 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.