Active NPI
Bryce Walter, LAT, AT-C
- Athletic Trainer
- Wichita, KS
National Provider Identifier
1801200449
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 24-00695
- Practice address
- 12112 W Kellogg St
Wichita, KS 67235-1100 - Phone
- (316) 440-1100
- Fax
- (316) 440-1089
- NPI assigned
- Jun 11, 2014
- 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 | 24-00695 | KS | Primary |
Addresses
Primary practice location
12112 W Kellogg St
Wichita, KS 67235-1100
Mailing address
12112 W Kellogg St
Wichita, KS 67235-1100
Phone (316) 440-1100
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
| License | State | Type | Specialty |
|---|---|---|---|
| 24-00695 | KS | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1402444800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1402444800000",
"number": "1801200449",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12112 W KELLOGG ST",
"city": "WICHITA",
"state": "KS",
"postal_code": "672351100",
"telephone_number": "316-440-1100",
"fax_number": "316-440-1089"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12112 W KELLOGG ST",
"city": "WICHITA",
"state": "KS",
"postal_code": "672351100",
"telephone_number": "316-440-1100",
"fax_number": "316-440-1089"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALTER",
"first_name": "BRYCE",
"credential": "LAT, AT-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-06-11",
"last_updated": "2014-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "KS",
"license": "24-00695",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wichita, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.