Active NPI
Michael T Lamere, ATC
- Athletic Trainer
- Green Bay, WI
National Provider Identifier
1356437594
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 406-039
- Practice address
- 760 Pilgrim Way
Green Bay, WI 54304-5263 - Phone
- (920) 496-4750
- NPI assigned
- Oct 5, 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 | 406-039 | WI | Primary |
Addresses
Primary practice location
760 Pilgrim Way
Green Bay, WI 54304-5263
Mailing address
1926 Erma Dr
Green Bay, WI 54302-3913
Phone (920) 469-0354
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 |
|---|---|---|---|
| 406-039 | WI | 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": "1183852800000",
"number": "1356437594",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1926 ERMA DR",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543023913",
"telephone_number": "920-469-0354"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "760 PILGRIM WAY",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543045263",
"telephone_number": "920-496-4750"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAMERE",
"first_name": "MICHAEL",
"middle_name": "T",
"name_prefix": "Mr.",
"credential": "ATC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-05",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "WI",
"license": "406-039",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Green Bay, 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.