Carli Megan Tebo, LAT

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

2308-39 Issued in WI

Practice address

1970 S Ridge Rd
Green Bay, WI 54304-4125

Phone

(920) 559-9013

NPI assigned

Aug 6, 2020

Last updated

Aug 6, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1596672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596672000000",
    "number": "1467062208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4143 GEMSTONE TRL",
            "city": "BELLEVUE",
            "state": "WI",
            "postal_code": "543119007",
            "telephone_number": "920-559-9013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1970 S RIDGE RD",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543044125",
            "telephone_number": "920-559-9013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEBO",
        "first_name": "CARLI",
        "middle_name": "MEGAN",
        "credential": "LAT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-06",
        "last_updated": "2020-08-06",
        "certification_date": "2020-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "WI",
            "license": "2308-39",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katelyn Taylor
• Martha Marie Taylor, PA-C
• Tanner Nichole Taylor, OD
• Angela Marie Tayson, MA, LPC
• David Seeger Tearse, MD
• Sheila M Teddy
• Amber Marie Teele, LPC, SAC, NCC
• Merle L Teetzen, MD
• Frank H Teller, LCSW
• Megan E Temp, M.D.

• Athletic Trainer in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Athletic Trainer in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2020; 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.