Stephen Waltersdorf, MS, AT, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

Practice address

2526 Sandwedge LN
Pinckney, MI 48169

Phone

(734) 474-0610

NPI assigned

Feb 19, 2015

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

Master of Science

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

{
    "created_epoch": "1424304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529452800000",
    "number": "1851783468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2526 SANDWEDGE LN",
            "city": "PINCKNEY",
            "state": "MI",
            "postal_code": "481699185",
            "telephone_number": "734-474-0610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2526 SANDWEDGE LN",
            "city": "PINCKNEY",
            "state": "MI",
            "postal_code": "48169",
            "telephone_number": "734-474-0610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTERSDORF",
        "first_name": "STEPHEN",
        "credential": "MS, AT, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-02-19",
        "last_updated": "2018-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Athletic Trainer in Pinckney, MI
• Providers in Pinckney, MI by specialty
• Athletic Trainer in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2018; 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.