Elizabeth Walters, EDD, LAT, ATC, CES

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

36003297A Issued in IN

Practice address

200 E 186TH St
Westfield, IN 46074-2001

Phone

(419) 202-5917

NPI assigned

Jan 28, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

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": "1390867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579478400000",
    "number": "1871916783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 WYNDHAM LN",
            "city": "SANDUSKY",
            "state": "OH",
            "postal_code": "448707264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 E 186TH ST",
            "city": "WESTFIELD",
            "state": "IN",
            "postal_code": "460742001",
            "telephone_number": "419-202-5917"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1100 Wyndham Ln",
            "address_purpose": "LOCATION",
            "city": "Sandusky",
            "state": "OH",
            "postal_code": "448707264",
            "country_code": "US",
            "telephone_number": "419-202-5917",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALTERS",
        "first_name": "ELIZABETH",
        "credential": "EDD, LAT, ATC, CES",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-01-28",
        "last_updated": "2020-01-20",
        "certification_date": "2020-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MA",
            "license": "2344",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IN",
            "license": "36003297A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Athletic Trainer in Westfield, IN
• Providers in Westfield, IN by specialty
• Athletic Trainer in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2020; 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.