Active NPI
Kristopher Karl Hartz, ATC
- Athletic Trainer
- Waukesha, WI
National Provider Identifier
1114090628
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 175-039
- Practice address
- 100 N East Ave
Waukesha, WI 53186-3103 - Phone
- (262) 524-7701
- NPI assigned
- Nov 15, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 175-039 | WI | Primary |
Addresses
Primary practice location
100 N East Ave
Waukesha, WI 53186-3103
Mailing address
2218 S Mound St
Milwaukee, WI 53207-1334
Phone (414) 483-0588
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
| License | State | Type | Specialty |
|---|---|---|---|
| 175-039 | WI | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163548800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1114090628",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2218 S MOUND ST",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532071334",
"telephone_number": "414-483-0588"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 N EAST AVE",
"city": "WAUKESHA",
"state": "WI",
"postal_code": "531863103",
"telephone_number": "262-524-7701"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARTZ",
"first_name": "KRISTOPHER",
"middle_name": "KARL",
"credential": "ATC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "WI",
"license": "175-039",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waukesha, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.