Active NPI
Renee Reckelberg, ATC
- Athletic Trainer
- Milwaukee, WI
National Provider Identifier
1528556255
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 777-039
- Practice address
- 3409 North Downer Avenue
Pavilion, Suite 350
Milwaukee, WI 53211 - Phone
- (217) 714-1170
- NPI assigned
- Apr 27, 2018
- Sex
- Female
- Sole proprietor
- No
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 | 777-039 | WI | Primary |
Addresses
Primary practice location
3409 North Downer Avenue
Pavilion, Suite 350
Milwaukee, WI 53211
Mailing address
3010 E Emily Ave
Oak Creek, WI 53154-3465
Phone (217) 714-1170
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
| License | State | Type | Specialty |
|---|---|---|---|
| 777-039 | WI | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1524787200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1524787200000",
"number": "1528556255",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3010 E EMILY AVE",
"city": "OAK CREEK",
"state": "WI",
"postal_code": "531543465",
"telephone_number": "217-714-1170"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3409 NORTH DOWNER AVENUE",
"address_2": "PAVILION, SUITE 350",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "53211",
"telephone_number": "217-714-1170"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RECKELBERG",
"first_name": "RENEE",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-04-27",
"last_updated": "2018-04-27",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "WI",
"license": "777-039",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Milwaukee, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.