Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. Caleb Diederich, ATC, LAT

Individual provider Athletic Trainer · NPI 1306581434

Mr. Caleb Diederich, ATC, LAT is an Athletic Trainer in Kansas City, Missouri. Licensed in Kansas and Missouri. Registered with an NPI since 2022.

Licensed in
KS, MO
In the registry since
2022
Specialties on file
2
What do these letters mean?
ATC — Certified Athletic Trainer
Prevents and treats sport and activity injuries.
LAT — Licensed Athletic Trainer
A state-licensed athletic trainer.

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Practice location Address checks out

2401 Gillham Rd
Kansas City, MO 64108-4619
Phone: (816) 234-3000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Athletic Trainer (primary) Taxonomy 2255A2300X · Licence 24-01018 (KS)
Athletic Trainer Taxonomy 2255A2300X · Licence 05-35604 (MO)

Record details

NPI number1306581434
Entity typeIndividual (Type 1)
GenderMale
Credentials ATC , LAT
Sole proprietorNo
NPI enumeratedMay 3, 2022
Last updated in NPPESMay 3, 2022
Certification dateMay 3, 2022

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