Active NPI
Garrett Vucenic, LAT
- Athletic Trainer
- Kenosha, WI
National Provider Identifier
1487048989
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- Practice address
- 7610 Pershing Blvd
Kenosha, WI 53142-4318 - Phone
- (715) 296-0132
- NPI assigned
- Mar 23, 2015
- Sex
- Male
- Sole proprietor
- Yes
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 | Primary |
Addresses
Primary practice location
7610 Pershing Blvd
Kenosha, WI 53142-4318
Mailing address
5815 5TH Ave Apt 415
Kenosha, WI 53140-4207
Phone (715) 296-0132
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1427068800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1488240000000",
"number": "1487048989",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5815 5TH AVE APT 415",
"city": "KENOSHA",
"state": "WI",
"postal_code": "531404207",
"telephone_number": "715-296-0132"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7610 PERSHING BLVD",
"city": "KENOSHA",
"state": "WI",
"postal_code": "531424318",
"telephone_number": "715-296-0132"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VUCENIC",
"first_name": "GARRETT",
"credential": "LAT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-03-23",
"last_updated": "2017-02-28",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kenosha, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.