Bethany Funk, LAT, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

Practice address

4606 Siggelkow Rd Apt 208
MC Farland, WI 53558-8777

Phone

(608) 770-4160

NPI assigned

Mar 21, 2017

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1490054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537920000000",
    "number": "1619408846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4606 SIGGELKOW RD APT 208",
            "city": "MC FARLAND",
            "state": "WI",
            "postal_code": "535588777",
            "telephone_number": "608-770-4160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4606 SIGGELKOW RD APT 208",
            "city": "MC FARLAND",
            "state": "WI",
            "postal_code": "535588777",
            "telephone_number": "608-770-4160"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "923 Harlocke St Apt 1",
            "address_purpose": "LOCATION",
            "city": "Iowa City",
            "state": "IA",
            "postal_code": "522465100",
            "country_code": "US",
            "telephone_number": "563-380-2601",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FUNK",
        "first_name": "BETHANY",
        "credential": "LAT, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-21",
        "last_updated": "2018-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "WI",
            "license": null,
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kendall Deutsch, RN
• David Bruce Downie, RPH
• Lynn Enter, PT
• Rachael Erickson, LPC
• Gail Barbara Freedman, RN
• James Morlee Garwo, REGISTERED NURSE
• John Glover, LCSW
• Laura Gross, SLP
• James Haines, PHARM.D.
• Thomas Nicholas Hansen, M.D.

• Athletic Trainer in MC Farland, WI
• Providers in MC Farland, WI by specialty
• Athletic Trainer in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 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.

Verify at the official NPI Registry.