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BLAKE WICKERHAM LAT, ATC
NPI 1275959876
Specialist/Technologist - Athletic Trainer in Raleigh, NC

Active since March 07, 2014
3121 WOODS PL, RALEIGH, NC 27607(919) 515-2111 Get Directions Write a Review

NPPES record last updated: March 7, 2014. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Blake Wickerham Lat, Atc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BLAKE WICKERHAM LAT, ATC (NPI 1275959876) is an individual athletic trainer provider in Raleigh, North Carolina, licensed in North Carolina (2254) and active in the NPI registry since March 2014.

NPPES Registry Identity

NPI1275959876
Entity TypeIndividualMale
Primary Taxonomy2255A2300X
Provider Legal NameBLAKE WICKERHAMCredential: LAT, ATC
Location Address3121 WOODS PLRaleigh, NC 27607-5231
Mailing Address3121 Woods PlRaleigh, NC 27607-5231 · (919) 515-2111
Phone(919) 515-2111
Sole ProprietorYes
Enumeration DateMarch 7, 2014
✔ NPI 1275959876 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialist/Technologist · Athletic TrainerRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code2255A2300X
License✔ Licensed in NC · 2254
Definition
Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-level employment requirements are a bachelor's degree with a major in athletic training from an accredited university or college. A majority of athletic trainers hold advanced degrees. National board certification is generally required as a condition of state licensure and employment. Most states regulate athletic trainers, and they practice within the scope of that license or regulation. Clinical practice includes emergency care, rehabilitation, reconditioning, therapeutic exercise, wellness programs, exercise physiology, kinesiology, biomechanics, nutrition, psychology and health care administration.
3121 WOODS PL, Raleigh, NC 27607
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Blake Wickerham's NPI number?

The NPI number for Blake Wickerham is 1275959876. It was assigned to this individual provider in the NPPES registry on March 7, 2014.

Where is Blake Wickerham located?

Blake Wickerham practices at 3121 Woods Pl, Raleigh, NC 27607. The listed phone number is (919) 515-2111.

What is Blake Wickerham's specialty?

The primary specialty registered for this NPI is Specialist/Technologist, specializing in Athletic Trainer, with taxonomy code 2255A2300X.

When was this NPI record last updated?

The NPPES record for Blake Wickerham was last updated on March 7, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.