Amanda Louise Traxler, MS, LAT, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

36001853A Issued in IN

Practice address

3946 Ice Way
Fort Wayne, IN 46805-1018

Phone

(260) 266-7400

Fax

(260) 266-4008

NPI assigned

Jan 26, 2012

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1327536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654041600000",
    "number": "1972874667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11109 PARKVIEW PLAZA DR # 117",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3946 ICE WAY",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468051018",
            "telephone_number": "260-266-7400",
            "fax_number": "260-266-4008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAXLER",
        "first_name": "AMANDA",
        "middle_name": "LOUISE",
        "name_prefix": "Ms.",
        "credential": "MS, LAT, ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-01-26",
        "last_updated": "2022-06-01",
        "certification_date": "2022-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IN",
            "license": "36001853A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amanda.traxler@parkview.com",
            "affiliation": "N",
            "address_1": "3946 Ice Way",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468051018",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Johnell J Treesh-Valentine, ADULT NP, MS
• Felicia Treesh
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• Allison Treleaven, O.D.

• All providers in Fort Wayne, IN
• Athletic Trainer in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 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.