Individual provider Active NPI

McColm Thai Dien Pursell, ATC

  • Athletic Trainer
  • Des Moines, IA
National Provider Identifier
1578448882
Registry record updated Aug 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
Practice address
4600 NW 2ND St
Des Moines, IA 50313-2254
Phone
(913) 201-1807
NPI assigned
Aug 6, 2025
Last updated
Aug 6, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X IA Primary

Addresses

Primary practice location

4600 NW 2ND St
Des Moines, IA 50313-2254

Mailing address

2530 University Ave Apt 321
Des Moines, IA 50311-4517
Phone (913) 201-1807

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": "1754438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754438400000",
    "number": "1578448882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2530 UNIVERSITY AVE APT 321",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503114517",
            "telephone_number": "913-201-1807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 NW 2ND ST",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503132254",
            "telephone_number": "913-201-1807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PURSELL",
        "first_name": "MCCOLM",
        "middle_name": "THAI DIEN",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-08-06",
        "last_updated": "2025-08-06",
        "certification_date": "2025-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2025; 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.