Individual provider Active NPI

Kemery Jean Sigmund, ATC

  • Athletic Trainer
  • Mequon, WI
National Provider Identifier
1174636328
Registry record updated Jan 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
1568-39 Issued in WI
Practice address
12800 N Lake Shore Dr
Mequon, WI 53097-2418
Phone
(262) 243-4316
NPI assigned
Aug 15, 2006
Last updated
Jan 7, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 096.002301 IL
Athletic Trainer 2255A2300X 1568-39 WI Primary

Addresses

Primary practice location

12800 N Lake Shore Dr
Mequon, WI 53097-2418

Mailing address

12800 N Lake Shore Dr
Mequon, WI 53097-2418
Phone (262) 243-4316

Other practice location 1

215 5th St
Sports Medicine Department
Marietta, OH 45750-4033
Phone (404) 520-8017

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
096.002301ILMDAthletic Trainer
1568-39WIMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546819200000",
    "number": "1174636328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12800 N LAKE SHORE DR",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530972418",
            "telephone_number": "262-243-4316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12800 N LAKE SHORE DR",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530972418",
            "telephone_number": "262-243-4316"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "215 5th St",
            "address_2": "Sports Medicine Department",
            "address_purpose": "LOCATION",
            "city": "Marietta",
            "state": "OH",
            "postal_code": "457504033",
            "country_code": "US",
            "telephone_number": "404-520-8017",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIGMUND",
        "first_name": "KEMERY",
        "middle_name": "JEAN",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-15",
        "last_updated": "2019-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IL",
            "license": "096.002301",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "WI",
            "license": "1568-39",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mequon, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2019; 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.