Active NPI
Andrea Frances Kolodziej, ATC, LAT
- Athletic Trainer
- Oak Creek, WI
National Provider Identifier
1164518031
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 1144
- Practice address
- 7901 S 6TH St
Oak Creek, WI 53154-2010 - Phone
- (708) 860-5635
- NPI assigned
- Oct 5, 2006
- Sex
- Female
- Sole proprietor
- No
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 | 1144 | SC | Primary |
Addresses
Primary practice location
7901 S 6TH St
Oak Creek, WI 53154-2010
Mailing address
7901 S 6TH St
Oak Creek, WI 53154-2010
Phone (708) 860-5635
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 |
|---|---|---|---|
| 1144 | SC | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160006400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1729468800000",
"number": "1164518031",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7901 S 6TH ST",
"city": "OAK CREEK",
"state": "WI",
"postal_code": "531542010",
"telephone_number": "708-860-5635"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7901 S 6TH ST",
"city": "OAK CREEK",
"state": "WI",
"postal_code": "531542010",
"telephone_number": "708-860-5635"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOLODZIEJ",
"first_name": "ANDREA",
"middle_name": "FRANCES",
"credential": "ATC, LAT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-05",
"last_updated": "2024-10-21",
"certification_date": "2024-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "SC",
"license": "1144",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oak Creek, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 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.