Kaley Wilder, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AL4704 Issued in FL

Practice address

25 W Crystal Lake St Ste 200
Orlando, FL 32806-4476

Phone

(407) 254-2500

NPI assigned

Aug 23, 2017

Sex

Female

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

State licenses

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

{
    "created_epoch": "1503446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1504656000000",
    "number": "1649797523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2536 GALLIANO CIR",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327921512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 W CRYSTAL LAKE ST STE 200",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328064476",
            "telephone_number": "407-254-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILDER",
        "first_name": "KALEY",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-23",
        "last_updated": "2017-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "FL",
            "license": "AL4704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Katherine O'Toole Wilczak, APRN
• Wild Hearts Counseling LLC
• Lauren Wilda, DPT
• Roberta Ann Wildblood, PSYD, MS, RN
• Elizabeth R Wilder, DO
• Terry L Wilder, APRN
• Sherie J Wildermuth
• Kayla Donn Wilfley
• Wilfredo Rodriguez DMD PA
• Marc Richard Wilhelm, ARNP

• Athletic Trainer in Orlando, FL
• Providers in Orlando, FL by specialty
• Athletic Trainer in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2017; 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.