Active NPI
Sofia Wentz
- Athletic Trainer
- Fargo, ND
National Provider Identifier
1508451816
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 921-21
- Practice address
- 1340 Administration Ave
Fargo, ND 58105 - Phone
- (701) 231-8011
- NPI assigned
- Mar 8, 2021
- Last updated
- Jan 15, 2024
- Sex
- Female
- 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 | 921-21 | ND | Primary |
Addresses
Primary practice location
1340 Administration Ave
Fargo, ND 58105
Mailing address
1640 5TH St N
Fargo, ND 58102-2312
Phone (701) 516-2449
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 921-21 | ND | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1615161600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1705276800000",
"number": "1508451816",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1640 5TH ST N",
"city": "FARGO",
"state": "ND",
"postal_code": "581022312",
"telephone_number": "701-516-2449"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1340 ADMINISTRATION AVE",
"city": "FARGO",
"state": "ND",
"postal_code": "58105",
"telephone_number": "701-231-8011"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WENTZ",
"first_name": "SOFIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-03-08",
"last_updated": "2024-01-15",
"certification_date": "2024-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "ND",
"license": "921-21",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fargo, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 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.