Ethan David Wilkinson-Felgate

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

Practice address

507 Donaldson St
Canton, MO 63435-1101

Phone

(573) 383-4595

NPI assigned

Jan 16, 2026

Sex

Male

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 16, 2026.

{
    "created_epoch": "1768521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768521600000",
    "number": "1700745700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "507 DONALDSON ST",
            "city": "CANTON",
            "state": "MO",
            "postal_code": "634351101",
            "telephone_number": "573-383-4595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "507 DONALDSON ST",
            "city": "CANTON",
            "state": "MO",
            "postal_code": "634351101",
            "telephone_number": "573-383-4595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKINSON-FELGATE",
        "first_name": "ETHAN",
        "middle_name": "DAVID",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-01-16",
        "last_updated": "2026-01-16",
        "certification_date": "2026-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Stark, PHARMD
• Allyson R Swank
• Christe Anne Thomas, ATC
• Champ Clark Todd, DDS
• Jillian Katherine Vervynck
• Jalen Wilson

• All providers in Canton, MO
• Athletic Trainer in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2026; 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.