Individual provider Active NPI

Justin Michel Wenzel, ATC

  • Athletic Trainer
  • Nashville, TN
National Provider Identifier
1780643171
Registry record updated Aug 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
974 Issued in TN
Practice address
2601 Jess Neely Dr
166 McGugin
Nashville, TN 37212-2039
Phone
(615) 343-7763
Fax
(615) 343-2592
NPI assigned
Mar 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2007

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 974 TN Primary

Addresses

Primary practice location

2601 Jess Neely Dr
166 McGugin
Nashville, TN 37212-2039

Mailing address

2601 Jess Neely Dr
Nashville, TN 37212-2039
Phone (615) 343-7763

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

State licenses

LicenseStateTypeSpecialty
974TNMDHearing Instrument Specialist

NPI Registry JSON

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

{
    "created_epoch": "1142985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187308800000",
    "number": "1780643171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2601 JESS NEELY DR",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372122039",
            "telephone_number": "615-343-7763",
            "fax_number": "615-343-2592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 JESS NEELY DR",
            "address_2": "166 MCGUGIN",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372122039",
            "telephone_number": "615-343-7763",
            "fax_number": "615-343-2592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENZEL",
        "first_name": "JUSTIN",
        "middle_name": "MICHEL",
        "name_prefix": "Mr.",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-22",
        "last_updated": "2007-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "TN",
            "license": "974",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2007; 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.