Cordial M. Gillette, PHD, AT, LAT

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

613-039 Issued in WI

Practice address

1725 State St.
214 Mitchell Hall
La Crosse, WI 54601-3742

Phone

(608) 785-8196

Fax

(608) 785-6561

NPI assigned

Feb 15, 2006

Sex

Female

Sole proprietor

No

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

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• University of Wisconsin - la Crosse

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • La Crosse, WI
  • NPI 1386368041
  NPD

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

{
    "created_epoch": "1139961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673654400000",
    "number": "1477527596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1725 STATE ST",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546013742",
            "telephone_number": "608-785-8196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1725 STATE ST.",
            "address_2": "214 MITCHELL HALL",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546013742",
            "telephone_number": "608-785-8196",
            "fax_number": "608-785-6561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLETTE",
        "first_name": "CORDIAL",
        "middle_name": "M.",
        "name_prefix": "Mrs.",
        "credential": "PHD, AT, LAT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-15",
        "last_updated": "2023-01-14",
        "certification_date": "2023-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "WI",
            "license": "613-039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mattie Gilbertson
• Terry Ann Giles, BSW
• Paula Gill, MD
• Effie Lynn Gilles, BSW
• Amanda Mae Gillette
• Gina Gillitzer
• Alexis Rose Gilmore
• Amanda Gingrasso, NP
• Anne Elizabeth Gisvold, APNP
• Andrea Katherine Glandt

• Athletic Trainer in La Crosse, WI
• Providers in La Crosse, WI by specialty
• Athletic Trainer in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2023; 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.