Individual provider Active NPI

Kaitlyn Wentz

  • Athletic Trainer
  • Houston, TX
National Provider Identifier
1487409603
Registry record updated Apr 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
Practice address
4300 Martin Luther King Blvd
Houston, TX 77204-3067
Phone
(713) 743-2255
NPI assigned
Apr 22, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Athletic Trainer 2255A2300X Primary

Addresses

Primary practice location

4300 Martin Luther King Blvd
Houston, TX 77204-3067

Mailing address

3692 Haskell Hollow Loop
College Station, TX 77845-5315

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": "1713744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713744000000",
    "number": "1487409603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3692 HASKELL HOLLOW LOOP",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778455315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 MARTIN LUTHER KING BLVD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772043067",
            "telephone_number": "713-743-2255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENTZ",
        "first_name": "KAITLYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-22",
        "last_updated": "2024-04-22",
        "certification_date": "2024-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2024; 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.