Active NPI
Grace Elizabeth Cortez, LAT
- Athletic Trainer
- Mount Pleasant, WI
National Provider Identifier
1396134524
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 39-744
- Practice address
- 3801 Spring St
Orthopedic Department
Mount Pleasant, WI 53405-1667 - Phone
- (262) 687-5838
- NPI assigned
- Jan 12, 2015
- 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 | 39-744 | WI | Primary |
Addresses
Primary practice location
3801 Spring St
Orthopedic Department
Mount Pleasant, WI 53405-1667
Mailing address
175 Devlin Rd Apt 202
Ingleside, IL 60041-9714
Phone (815) 757-5111
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 |
|---|---|---|---|
| 39-744 | WI | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1421020800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1557446400000",
"number": "1396134524",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "175 DEVLIN RD APT 202",
"city": "INGLESIDE",
"state": "IL",
"postal_code": "600419714",
"telephone_number": "815-757-5111"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3801 SPRING ST",
"address_2": "ORTHOPEDIC DEPARTMENT",
"city": "MOUNT PLEASANT",
"state": "WI",
"postal_code": "534051667",
"telephone_number": "262-687-5838"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORTEZ",
"first_name": "GRACE",
"middle_name": "ELIZABETH",
"credential": "LAT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-01-12",
"last_updated": "2019-05-10",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "WI",
"license": "39-744",
"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 May 10, 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.