KATELYNN MARIE WALSH, MS, LAT, ATC, EMT — NPI 1003479965 (Licensed & Credentialed Specialist/Technologist, Athletic Trainer in WACONIA, MN)

CMS-1500 Box 24J / 33a • NPI

1003479965

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

2255A2300X

Licensed & Credentialed Specialist/Technologist, Athletic Trainer

Box 32 Service Location & ZIP+4

560 S MAPLE ST, WACONIA, MN, 55387-1733

✓ 9-Digit EDI 837 ZIP+4 (55387-1733)

Practice Phone & Referral Fax

(952) 843-8505

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1003479965 (KATELYNN MARIE WALSH, MS, LAT, ATC, EMT) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1003479965` (NPI-1 Individual Practitioner)
Provider / Legal Name	KATELYNN MARIE WALSH, MS, LAT, ATC, EMT
Plain-English Specialty	Licensed & Credentialed Specialist/Technologist, Athletic Trainer NUCC Code: `2255A2300X` (Specialist/Technologist, Athletic Trainer)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	560 S MAPLE ST, WACONIA, MN, 55387-1733
Practice Telephone / Fax	Tel: (952) 843-8505
Administrative Mailing Address	PO BOX 282, CARVER, MN, 55315-0282
Enumeration & Last Sync	Enumerated: 2019-04-17 \| CMS Record Updated: 2023-03-23

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

560 S MAPLE ST, WACONIA, MN, 55387-1733

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Plain-English Taxonomy & CMS Crosswalk (2255A2300X)

What Does Taxonomy Code 2255A2300X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 2255A2300X translates to:
"Licensed & Credentialed Specialist/Technologist, Athletic Trainer"

CMS-1500 Medicare Specialty Crosswalk: Standard HIPAA X12N 837P / CMS-1500
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Specialist/Technologist, Athletic Trainer for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (KATELYNN MARIE WALSH, MS, LAT, ATC, EMT)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`390200000X` — Student in an Organized Health Care Education/Training Program Plain English: Licensed & Credentialed Student in an Organized Health Care Education/Training Program	State: N/A \| License: `Verified` \| Primary: Secondary
`2255A2300X` — Specialist/Technologist, Athletic Trainer Plain English: Licensed & Credentialed Specialist/Technologist, Athletic Trainer	State: MN \| License: `3359` \| Primary: Yes (Primary)

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KATELYNN MARIE WALSH, MS, LAT, ATC, EMT (NPI #1003479965)