Active NPI
Walter Lee Hildebrand III, MS, ATC, LAT, CSCS
- Athletic Trainer
- Shrewsbury, MA
National Provider Identifier
1720459530
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AH2216-AT
- Practice address
- 904C Boston Tpke
Shrewsbury, MA 01545-3303 - Phone
- (508) 845-3500
- NPI assigned
- Oct 19, 2015
- Sex
- Male
- 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 | AH2216-AT | MA | Primary |
Addresses
Primary practice location
904C Boston Tpke
Shrewsbury, MA 01545-3303
Mailing address
904C Boston Tpke
Shrewsbury, MA 01545-3303
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AH2216-AT | MA | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1445212800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1445212800000",
"number": "1720459530",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "904C BOSTON TPKE",
"city": "SHREWSBURY",
"state": "MA",
"postal_code": "015453303"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "904C BOSTON TPKE",
"city": "SHREWSBURY",
"state": "MA",
"postal_code": "015453303",
"telephone_number": "508-845-3500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HILDEBRAND",
"first_name": "WALTER",
"middle_name": "LEE",
"name_prefix": "Mr.",
"name_suffix": "III",
"credential": "MS, ATC, LAT, CSCS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-10-19",
"last_updated": "2015-10-19",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "MA",
"license": "AH2216-AT",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shrewsbury, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.