Active NPI
Wendy Corelli, MS, AT., ATC
- Athletic Trainer
- Grand Rapids, MI
National Provider Identifier
1801204805
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 2601000718
- Practice address
- 6191 Kraft Ave SE
Grand Rapids, MI 49512-9396 - Phone
- (616) 871-6186
- NPI assigned
- Jul 23, 2014
- Sex
- Female
- 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 | 2601000718 | MI | Primary |
Addresses
Primary practice location
6191 Kraft Ave SE
Grand Rapids, MI 49512-9396
Mailing address
15096 Oakland St
Spring Lake, MI 49456-2721
Phone (616) 566-7924
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 |
|---|---|---|---|
| 2601000718 | MI | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1406073600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1406073600000",
"number": "1801204805",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15096 OAKLAND ST",
"city": "SPRING LAKE",
"state": "MI",
"postal_code": "494562721",
"telephone_number": "616-566-7924"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6191 KRAFT AVE SE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495129396",
"telephone_number": "616-871-6186"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORELLI",
"first_name": "WENDY",
"credential": "MS, AT., ATC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-07-23",
"last_updated": "2014-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "MI",
"license": "2601000718",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.