Andrew Wesdock, ATC, LAT

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

A0000959 Issued in MD

Practice address

629 Hickory Overlook Dr
Bel Air, MD 21014-1864

Phone

(443) 243-8338

NPI assigned

May 11, 2018

Last updated

May 11, 2018By the provider in NPPES

Sex

Male

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": "1525996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525996800000",
    "number": "1942790258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "629 HICKORY OVERLOOK DR",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210141864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "629 HICKORY OVERLOOK DR",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210141864",
            "telephone_number": "443-243-8338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WESDOCK",
        "first_name": "ANDREW",
        "credential": "ATC, LAT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-05-11",
        "last_updated": "2018-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "DE",
            "license": "J3-0000712",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MD",
            "license": "A0000959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Glynn M. Wells, M.D.
• Wellspring Clinic LLC
• Wellspring Clinic LLC
• Wellspring Clinic LLC
• Wellspring Realty Corp (Wellspring ASC)
• Nicholas Michael Wesley
• Katharine West, PA-C
• Elizabeth Westendorf
• Wheelchairability LLC (Wheelchair Transportation)
• Amber Larue Wheeler-Taylor, CRNP

• Athletic Trainer in Bel Air, MD
• Providers in Bel Air, MD by specialty
• Athletic Trainer in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 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.