Active NPI
Kayla A Huerta, LAT, ATC
- Athletic Trainer
- Pewaukee, WI
National Provider Identifier
1407355498
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 1721-39
- Practice address
- 285 Forest Grove Dr Ste 207
Pewaukee, WI 53072-3738 - Phone
- (877) 732-2262
- NPI assigned
- Feb 6, 2018
- 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 | 1721-39 | WI | Primary |
Addresses
Primary practice location
285 Forest Grove Dr Ste 207
Pewaukee, WI 53072-3738
Mailing address
700 W Rock Place
Glendale, WI 53209
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 22 | Other | WI | RESPIRATORY,REHABILITATIVE & RESTORATIVE SERVICE PROVIDER |
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 |
|---|---|---|---|
| 1721-39 | WI | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1517875200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1517875200000",
"number": "1407355498",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "700 W ROCK PLACE",
"city": "GLENDALE",
"state": "WI",
"postal_code": "53209"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "285 FOREST GROVE DR STE 207",
"city": "PEWAUKEE",
"state": "WI",
"postal_code": "530723738",
"telephone_number": "877-732-2262"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUERTA",
"first_name": "KAYLA",
"middle_name": "A",
"credential": "LAT, ATC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-02-06",
"last_updated": "2018-02-06",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "WI",
"license": "1721-39",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RESPIRATORY,REHABILITATIVE & RESTORATIVE SERVICE PROVIDER",
"identifier": "22",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pewaukee, WI
- Amanda Hoffman, APNP
- Daniel Patrick Holub, M.D.
- Angela Hook, M.S., LPC-IT
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- Infectious Disease Specialists, SC
- Inner Awakenings Diagnostic and Counseling Clinic
- Integrative Dental Solutions LLC
- Integrative Manual Physical Therapy, LLC
- J&P Haririe Midlevel Healthcare Associates
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.