Active NPI
Dallas Fichtner, LAT, ATC
- Athletic Trainer
- Lincoln, NE
National Provider Identifier
1710418488
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 447
- Practice address
- 5000 Saint Paul Ave
Lincoln, NE 68504-2760 - Phone
- (402) 465-7545
- Fax
- (402) 465-2170
- NPI assigned
- Mar 24, 2017
- Sex
- Male
- Sole proprietor
- Yes
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 | 447 | NE | Primary |
Addresses
Primary practice location
5000 Saint Paul Ave
Lincoln, NE 68504-2760
Mailing address
5000 Saint Paul Ave
Lincoln, NE 68504-2760
Phone (402) 465-7545
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 070502260 | Other | BOARD OF CERTIFICATION ATHLETIC TRAINING CERTIFIED | |
| 447 | Other | NE | DEPARTMENT OF HEALTH AND HUMAN SERVICES ATHLETIC TRAINING LICENSE |
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": "1490313600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1490313600000",
"number": "1710418488",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5000 SAINT PAUL AVE",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685042760",
"telephone_number": "402-465-7545",
"fax_number": "402-465-2170"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5000 SAINT PAUL AVE",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685042760",
"telephone_number": "402-465-7545",
"fax_number": "402-465-2170"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FICHTNER",
"first_name": "DALLAS",
"credential": "LAT, ATC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-03-24",
"last_updated": "2017-03-24",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "NE",
"license": "447",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BOARD OF CERTIFICATION ATHLETIC TRAINING CERTIFIED",
"identifier": "070502260",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEPARTMENT OF HEALTH AND HUMAN SERVICES ATHLETIC TRAINING LICENSE",
"identifier": "447",
"state": "NE"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lincoln, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 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.