Active NPI
Elias Wangaard, ATC
- Athletic Trainer
- Gardendale, AL
National Provider Identifier
1942600804
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 1012
- Practice address
- 592 Fieldstown Rd
116
Gardendale, AL 35071-3414 - Phone
- (205) 608-3606
- NPI assigned
- Aug 28, 2014
- Last updated
- Aug 28, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 1012 | AL | Primary |
Addresses
Primary practice location
592 Fieldstown Rd
116
Gardendale, AL 35071-3414
Mailing address
592 Fieldstown Rd
116
Gardendale, AL 35071-3414
Phone (205) 608-3606
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1012 | AL | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1409184000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1409184000000",
"number": "1942600804",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "592 FIELDSTOWN RD",
"address_2": "116",
"city": "GARDENDALE",
"state": "AL",
"postal_code": "350713414",
"telephone_number": "205-608-3606"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "592 FIELDSTOWN RD",
"address_2": "116",
"city": "GARDENDALE",
"state": "AL",
"postal_code": "350713414",
"telephone_number": "205-608-3606"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WANGAARD",
"first_name": "ELIAS",
"name_prefix": "Mr.",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-08-28",
"last_updated": "2014-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "AL",
"license": "1012",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gardendale, AL
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- Walgreen Co (Walgreens #06488)
- Kadijah Walker-Carson, RBT
- Paul Ward, MD/MPH
- Jennifer Haught Ware, DNP, FNP-C
- Timothy Watkins, NP
- West Point Optical Group
- Jeffrey Seth West, CRNP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.