Active NPI
Michael Baese, MS, LAT, ATC
- Athletic Trainer
- Milwaukee, WI
National Provider Identifier
1730344532
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 2007024550
- Practice address
- 2901 W Kinnickinnic River Pkwy
Suite 102
Milwaukee, WI 53215-3677 - Phone
- (414) 540-3304
- NPI assigned
- Jul 22, 2008
- Last updated
- Sep 22, 2010
- 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 | 2007024550 | MO | Primary |
Addresses
Primary practice location
2901 W Kinnickinnic River Pkwy
Suite 102
Milwaukee, WI 53215-3677
Mailing address
217 Green Bay Rd
Apt C
Thiensville, WI 53092-1651
Phone (314) 681-5927
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2007024550 | MO | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1216684800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1285113600000",
"number": "1730344532",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "217 GREEN BAY RD",
"address_2": "APT C",
"city": "THIENSVILLE",
"state": "WI",
"postal_code": "530921651",
"telephone_number": "314-681-5927"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2901 W KINNICKINNIC RIVER PKWY",
"address_2": "SUITE 102",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532153677",
"telephone_number": "414-540-3304"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAESE",
"first_name": "MICHAEL",
"credential": "MS, LAT, ATC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-07-22",
"last_updated": "2010-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "MO",
"license": "2007024550",
"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 Sep 22, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.