Individual provider Active NPI

Bridget A Sorenson, LAT

  • Athletic Trainer
  • Mount Pleasant, WI
National Provider Identifier
1376107433
Registry record updated Apr 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
1819 Issued in WI
Practice address
3811 Spring St
Mount Pleasant, WI 53405-1667
Phone
(262) 687-5838
NPI assigned
Apr 24, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 24, 2019

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 1819 WI Primary

Addresses

Primary practice location

3811 Spring St
Mount Pleasant, WI 53405-1667

Mailing address

4923 7 Mile Rd
Racine, WI 53402-1033
Phone (262) 902-5483

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
1819WIMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1556064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556064000000",
    "number": "1376107433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4923 7 MILE RD",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534021033",
            "telephone_number": "262-902-5483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3811 SPRING ST",
            "city": "MOUNT PLEASANT",
            "state": "WI",
            "postal_code": "534051667",
            "telephone_number": "262-687-5838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SORENSON",
        "first_name": "BRIDGET",
        "middle_name": "A",
        "credential": "LAT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-24",
        "last_updated": "2019-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "WI",
            "license": "1819",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Pleasant, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 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.