Shelby Nicolle Witschen Schmidt, MIT, LAT, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AL5464 Issued in FL

Practice address

102 Woodbine Cir
Fort Walton Beach, FL 32548-3538

Phone

(206) 777-5328

NPI assigned

Jul 30, 2018

Last updated

Sep 12, 2021By the provider in NPPES

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

Other names 1

• Shelby Nicolle Witschen Former name

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": "1532908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631404800000",
    "number": "1962980367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 WOODBINE CIR",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325483538",
            "telephone_number": "206-777-5328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 WOODBINE CIR",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325483538",
            "telephone_number": "206-777-5328"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10809 Rosin Jaw Trl",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782453747",
            "country_code": "US",
            "telephone_number": "206-777-5328",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHMIDT",
        "first_name": "SHELBY",
        "middle_name": "NICOLLE WITSCHEN",
        "credential": "MIT, LAT, ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-30",
        "last_updated": "2021-09-12",
        "certification_date": "2021-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "TX",
            "license": "AT6104",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "FL",
            "license": "AL5464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHELBY",
            "last_name": "WITSCHEN",
            "middle_name": "NICOLLE",
            "credential": "MIT, LAT, ATC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Satori Counseling, LLC
• Ella Sayers, RBT
• Sidney Scarborough
• Thor Jason Schaefer, DC
• Emilie Schmidt, DPT, SCS, ATC, CSCS
• Rosemarie M Schultz, MD
• Gregory Allen Schwartz, PHARMD
• Laurie Ann Schweppe, ARNP
• Leah Scofield
• Scooter Brothers Enterprises, LLC

• Athletic Trainer in Fort Walton Beach, FL
• Providers in Fort Walton Beach, FL by specialty
• Athletic Trainer in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2021; 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.