Individual provider Active NPI

Noel Kruse, ATC, LAT

  • Athletic Trainer
  • Milwaukee, WI
National Provider Identifier
1033948211
Registry record updated Jul 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
317239 Issued in WI
Practice address
770 N 12TH St
Milwaukee, WI 53233-2203
Phone
(414) 288-6303
NPI assigned
Jul 29, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 317239 WI Primary

Addresses

Primary practice location

770 N 12TH St
Milwaukee, WI 53233-2203

Mailing address

945 N 12TH St Ste 1100
Milwaukee, WI 53233-1305

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

State licenses

LicenseStateTypeSpecialty
317239WIMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1722211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722211200000",
    "number": "1033948211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "945 N 12TH ST STE 1100",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532331305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 N 12TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532332203",
            "telephone_number": "414-288-6303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUSE",
        "first_name": "NOEL",
        "credential": "ATC, LAT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-29",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "WI",
            "license": "317239",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2024; 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.