Active NPI
Brooke Dirks, LAT, ATC
- Athletic Trainer
- Waukee, IA
National Provider Identifier
1548049547
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 093786
- Practice address
- 655 10TH St
Waukee, IA 50263-6609 - Phone
- (515) 745-4867
- NPI assigned
- Sep 27, 2023
- 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 | 093786 | IA | Primary |
Addresses
Primary practice location
655 10TH St
Waukee, IA 50263-6609
Mailing address
210 NW Cedarwood Dr
Ankeny, IA 50023-5019
Phone (515) 745-4867
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 |
|---|---|---|---|
| 093786 | IA | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1695772800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1695772800000",
"number": "1548049547",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "210 NW CEDARWOOD DR",
"city": "ANKENY",
"state": "IA",
"postal_code": "500235019",
"telephone_number": "515-745-4867"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "655 10TH ST",
"city": "WAUKEE",
"state": "IA",
"postal_code": "502636609",
"telephone_number": "515-745-4867"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIRKS",
"first_name": "BROOKE",
"credential": "LAT, ATC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-09-27",
"last_updated": "2023-09-27",
"certification_date": "2023-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "IA",
"license": "093786",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waukee, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.