Active NPI
Wyatt Whitegoat
- Athletic Trainer
- Washington, DC
National Provider Identifier
1972006484
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- Practice address
- 5200 2ND St NW
Washington, DC 20011-6622 - Phone
- (202) 223-1111
- NPI assigned
- Mar 10, 2018
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Athletic Trainer | 2255A2300X | Primary |
Addresses
Primary practice location
5200 2ND St NW
Washington, DC 20011-6622
Mailing address
5200 2ND St NW
Washington, DC 20011-6622
Other practice location 1
1088 N and South Rd
Saint Louis, MO 63130-2114
Phone (928) 550-2795
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1520640000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1564963200000",
"number": "1972006484",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5200 2ND ST NW",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200116622"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5200 2ND ST NW",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200116622",
"telephone_number": "202-223-1111"
}
],
"practiceLocations": [
{
"address_1": "1088 N and South Rd",
"address_purpose": "LOCATION",
"city": "Saint Louis",
"state": "MO",
"postal_code": "631302114",
"country_code": "US",
"telephone_number": "928-550-2795",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WHITEGOAT",
"first_name": "WYATT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-03-10",
"last_updated": "2019-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Washington, DC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.