Alberto Jose Wawrzyniak, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AT006476 Issued in OH

Practice address

300 College Park Cronin Athletic Center
Dayton, OH 45469-1044

Phone

(937) 229-4460

Fax

(937) 229-5448

NPI assigned

Jan 8, 2019

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1546905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677110400000",
    "number": "1801369343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5626 NORTHVIEW DR",
            "city": "SYLVANIA",
            "state": "OH",
            "postal_code": "435602070",
            "telephone_number": "419-509-2549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 COLLEGE PARK CRONIN ATHLETIC CENTER",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454691044",
            "telephone_number": "937-229-4460",
            "fax_number": "937-229-5448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAWRZYNIAK",
        "first_name": "ALBERTO",
        "middle_name": "JOSE",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-01-08",
        "last_updated": "2023-02-23",
        "certification_date": "2023-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "OH",
            "license": "AT006476",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Athletic Trainer in Dayton, OH
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• Athletic Trainer in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2023; 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.