Individual provider Active NPI

Erin Marie Lally, ATC, MS

  • Athletic Trainer
  • Milwaukee, WI
National Provider Identifier
1770238032
Registry record updated Feb 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
2214-39 Issued in WI
Practice address
3409 N Downer Ave
Milwaukee, WI 53211-2934
Phone
(708) 259-4138
NPI assigned
Feb 15, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2022

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 2214-39 WI Primary

Addresses

Primary practice location

3409 N Downer Ave
Milwaukee, WI 53211-2934

Mailing address

3441 S Brust Ave
Milwaukee, WI 53207-3525
Phone (708) 259-4138

Other practice location 1

3409 N Downer Ave
Milwaukee, WI 53211-2934
Phone (708) 259-4138

Other practice location 2

3441 S Brust Ave
Milwaukee, WI 53207-3525
Phone (708) 259-4138

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
2214-39WIMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1644883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644883200000",
    "number": "1770238032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3441 S BRUST AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532073525",
            "telephone_number": "708-259-4138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3409 N DOWNER AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532112934",
            "telephone_number": "708-259-4138"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3409 N Downer Ave",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532112934",
            "country_code": "US",
            "telephone_number": "708-259-4138",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3441 S Brust Ave",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532073525",
            "country_code": "US",
            "telephone_number": "708-259-4138",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LALLY",
        "first_name": "ERIN",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "ATC, MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-15",
        "last_updated": "2022-02-15",
        "certification_date": "2022-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "WI",
            "license": "2214-39",
            "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 Feb 15, 2022; 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.