Charles Cole Victor Vertz, ATC, LAT

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

2020016742 Issued in MO

Practice address

704-A College St
Barton College
Wilson, NC 27893

Phone

(252) 399-6534

Fax

(252) 399-6516

NPI assigned

Nov 19, 2011

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": "1321660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662940800000",
    "number": "1942577929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4913 SUMMIT PLACE DR NW",
            "address_2": "#708",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "278968171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "704-A COLLEGE ST",
            "address_2": "BARTON COLLEGE",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "27893",
            "telephone_number": "252-399-6534",
            "fax_number": "252-399-6516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERTZ",
        "first_name": "CHARLES",
        "middle_name": "COLE VICTOR",
        "credential": "ATC, LAT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-11-19",
        "last_updated": "2022-09-12",
        "certification_date": "2022-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MO",
            "license": "2020016742",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dana Marie Varnell, PA-C
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• Vis Ta Vie Wellness and Spa
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• Athletic Trainer in Wilson, NC
• Providers in Wilson, NC by specialty
• Athletic Trainer in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2022; 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.