Individual provider Active NPI

Tracye N Menges, MS, ATC

  • Athletic Trainer
  • Lorain, OH
National Provider Identifier
1508078486
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
AT001337 Issued in OH
Practice address
5800 Cooper Foster Park Rd W
Lorain, OH 44053-4131
Phone
(440) 204-7800
Fax
(440) 204-7855
NPI assigned
May 4, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 AT001337 OH Primary

Addresses

Primary practice location

5800 Cooper Foster Park Rd W
Lorain, OH 44053-4131

Mailing address

1233 W 8TH St
Lorain, OH 44052-1561
Phone (440) 204-1136

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
AT001337OHMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508078486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1233 W 8TH ST",
            "city": "LORAIN",
            "state": "OH",
            "postal_code": "440521561",
            "telephone_number": "440-204-1136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5800 COOPER FOSTER PARK RD W",
            "city": "LORAIN",
            "state": "OH",
            "postal_code": "440534131",
            "telephone_number": "440-204-7800",
            "fax_number": "440-204-7855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENGES",
        "first_name": "TRACYE",
        "middle_name": "N",
        "credential": "MS, ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "OH",
            "license": "AT001337",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lorain, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.