Individual provider Active NPI

Elizabeth Kerrigan, LAT

  • Athletic Trainer
  • Baraboo, WI
National Provider Identifier
1477973873
Registry record updated Feb 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
1476-39 Issued in WI
Practice address
707 14TH St
Baraboo, WI 53913-1539
Phone
(608) 356-1480
NPI assigned
Apr 24, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2016

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 1476-39 WI Primary

Addresses

Primary practice location

707 14TH St
Baraboo, WI 53913-1539

Mailing address

554 Melody LN
Colgate, WI 53017-9796
Phone (262) 364-7569

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
1476-39WIMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1398297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455148800000",
    "number": "1477973873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "554 MELODY LN",
            "city": "COLGATE",
            "state": "WI",
            "postal_code": "530179796",
            "telephone_number": "262-364-7569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 14TH ST",
            "city": "BARABOO",
            "state": "WI",
            "postal_code": "539131539",
            "telephone_number": "608-356-1480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERRIGAN",
        "first_name": "ELIZABETH",
        "credential": "LAT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-24",
        "last_updated": "2016-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "WI",
            "license": "1476-39",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baraboo, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2016; 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.