Active NPI
Leah E Rutz, ATC, LAT
- Athletic Trainer
- Saint Peter, MN
National Provider Identifier
1568024081
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 2240-39
- Practice address
- 2121 Broadway Ave
Saint Peter, MN 56082-2258 - Phone
- (708) 256-1160
- NPI assigned
- Jul 4, 2019
- 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 | 2240-39 | WI | Primary |
Addresses
Primary practice location
2121 Broadway Ave
Saint Peter, MN 56082-2258
Mailing address
19518 Poplar St
Mokena, IL 60448-9323
Phone (708) 256-1160
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 |
|---|---|---|---|
| 2240-39 | WI | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1562198400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1562198400000",
"number": "1568024081",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19518 POPLAR ST",
"city": "MOKENA",
"state": "IL",
"postal_code": "604489323",
"telephone_number": "708-256-1160"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2121 BROADWAY AVE",
"city": "SAINT PETER",
"state": "MN",
"postal_code": "560822258",
"telephone_number": "708-256-1160"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUTZ",
"first_name": "LEAH",
"middle_name": "E",
"credential": "ATC, LAT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-07-04",
"last_updated": "2019-07-04",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "WI",
"license": "2240-39",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Peter, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.