Tanner Branch Wolf, ATC, LAT, MS, BS

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

0520 Issued in SD

Practice address

2905 3Rd Ave SE
Aberdeen, SD 57401-5420

Phone

(605) 626-4200

NPI assigned

Oct 14, 2024

Sex

Male

Sole proprietor

No

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

Credentials

Bachelor of Science, Master of Science

State licenses

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

{
    "created_epoch": "1728864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728864000000",
    "number": "1841010030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1610 S 7TH ST",
            "city": "ABERDEEN",
            "state": "SD",
            "postal_code": "574016830",
            "telephone_number": "605-222-7869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2905 3RD AVE SE",
            "city": "ABERDEEN",
            "state": "SD",
            "postal_code": "574015420",
            "telephone_number": "605-626-4200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2200 S Roosevelt St",
            "address_purpose": "LOCATION",
            "city": "Aberdeen",
            "state": "SD",
            "postal_code": "574018526",
            "country_code": "US",
            "telephone_number": "605-725-8100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOLF",
        "first_name": "TANNER",
        "middle_name": "BRANCH",
        "credential": "ATC, LAT, MS, BS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-10-14",
        "last_updated": "2024-10-14",
        "certification_date": "2024-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "SD",
            "license": "0520",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Barry J. Winkler, D.C.
• Andrew James Winterboer, CRNA
• Shelby Wipf
• Curt A Wischmeier, M.D.
• Garrett Manfred Wobst, DPM
• Danny A Wolfgram, MD
• Joann Gail Wren, RPH
• Lisa Beth Wurnig-Johnson, PA-C
• Anna Wyly, RN
• Nancy Yada

• Athletic Trainer in Aberdeen, SD
• Providers in Aberdeen, SD by specialty
• Athletic Trainer in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2024; 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.