Individual provider Active NPI

Carlee Wisniewski

  • Athletic Trainer
  • Fayetteville, AR
National Provider Identifier
1760075493
Registry record updated Feb 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
Practice address
1 University of Arkansas
Fayetteville, AR 72701-1201
Phone
(479) 575-2000
NPI assigned
Feb 13, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2021

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 Primary

Addresses

Primary practice location

1 University of Arkansas
Fayetteville, AR 72701-1201

Mailing address

640 N Wordsworth LN
Fayetteville, AR 72704-5127
Phone (708) 217-6164

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": "1613174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613174400000",
    "number": "1760075493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 N WORDSWORTH LN",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727045127",
            "telephone_number": "708-217-6164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 UNIVERSITY OF ARKANSAS",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727011201",
            "telephone_number": "479-575-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISNIEWSKI",
        "first_name": "CARLEE",
        "name_prefix": "Miss",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-13",
        "last_updated": "2021-02-13",
        "certification_date": "2021-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2021; 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.