MR. TODD HAROLD BRUSS (NPI# 1417178443) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417178443 |
| Entity Type | Individual |
| Full Name | MR. TODD HAROLD BRUSS |
| Credential | ATC, LAT, CSCS, PA-C |
| Practice Address |
1160 Kepler Dr Green Bay WI 54308-8970 |
| Mailing Address |
164 N Broadway Green Bay WI 54303-2728 |
| Practice Telephone | 9202885555 |
| Practice Fax Number | 9202885550 |
| Mailing Telephone | 9209654055 |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2013-09-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
350-039 | WI | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Y | 363A00000X | Physician Assistant | 3058 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 1417178443 | 05 |
| Street Address |
1160 KEPLER DR |
| City | GREEN BAY |
| State | WI |
| Zip Code | 54308-8970 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649273129 | Luke Thomas Warpinski | Family Medicine | 1160 Kepler Dr, Green Bay, WI 54311-8321 | 2005-05-27 |
| 1639783202 | Angela Dhuey | Massage Therapist | 1160 Kepler Dr, Green Bay, WI 54311-8321 | 2020-09-01 |
| 1912511585 | Marilee Petasek | Massage Therapist | 1160 Kepler Dr, Green Bay, WI 54311-8321 | 2020-09-01 |
| 1720611981 | Baycare Aurora, LLC | Durable Medical Equipment & Medical Supplies | 1160 Kepler Dr, Green Bay, WI 54311-8321 | 2020-02-17 |
| 1619448727 | Melissa Mary Thompson | Physical Therapist | 1160 Kepler Dr, Green Bay, WI 54311-8321 | 2018-12-16 |
| 1942776919 | Nathan Seitz | Physical Therapist | 1160 Kepler Dr, Green Bay, WI 54311-8321 | 2018-10-17 |
| 1679052104 | Amy E Warden | Nurse Practitioner | 1160 Kepler Dr, Green Bay, WI 54311-8321 | 2018-08-07 |
| 1477052553 | Kristin Kiekhaefer | Specialist/Technologist | 1160 Kepler Dr, Green Bay, WI 54311-8321 | 2018-02-05 |
| 1235647876 | Jordan Robinson | Specialist/Technologist | 1160 Kepler Dr, Green Bay, WI 54311-8321 | 2018-01-17 |
| 1811433816 | Paige E Pernaski | Registered Nurse | 1160 Kepler Dr, Green Bay, WI 54311-8321 | 2017-01-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962519066 | Merle L Teetzen | Physical Medicine & Rehabilitation | 2845 Greenbrier Rd, 1st Fl, Green Bay, WI 54308 | 2006-08-24 |
| 1356458897 | Russel J Kuzel | Family Medicine | 2845 Greenbrier Rd, 4th Floor, Green Bay, WI 54308 | 2006-08-23 |
| 1568579175 | Denise M Hess | Registered Nurse | 2845 Greenbrier Rd, Green Bay, WI 54308 | 2006-08-23 |
| 1619393659 | Stephanie Kennedy | Registered Nurse | 2845 Greenbrier Rd, Ste 330, Green Bay, WI 54308-8900 | 2014-03-14 |
| 1275867186 | Catherine M Patel | Physician Assistant | 2845 Greenbrier Rd, Green Bay, WI 54308-8900 | 2009-09-24 |
| 1306025085 | Terry Sue Betts | Physical Therapy Assistant | 2845 Greenbrier Rd, Green Bay, WI 54308-8900 | 2007-10-30 |
| 1699966499 | Bogdan Cristescu | Internal Medicine | 2845 Greenbrier Rd, Green Bay, WI 54308-8900 | 2007-08-06 |
| 1558478891 | Jill D Reimer | Nurse Practitioner | 2845 Greenbrier Rd, #420, Green Bay, WI 54308-8900 | 2006-08-24 |
| 1578670865 | Stephen F Sehring | Obstetrics & Gynecology | 2845 Greenbrier Rd, #480, Green Bay, WI 54308-8900 | 2006-08-24 |
| 1225145428 | Donald R Sipes | Obstetrics & Gynecology | 2845 Greenbrier Rd, #430, Green Bay, WI 54308-8900 | 2006-08-24 |
| Find all providers in zip 54308 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700253101 | Mathias Dahnert | Physician Assistant | 945 S Irwin Ave, Green Bay, WI 54301-3309 | 2015-09-01 |
| 1770992067 | Sheila M Teddy | Physician Assistant | 2595 Development Dr Ste 150, Green Bay, WI 54311-4288 | 2014-08-12 |
| 1245652718 | Bailey Bauer | Physician Assistant | 2753 Mayline Dr, Green Bay, WI 54311-9646 | 2014-01-17 |
| 1588949333 | Carissa Ann Coorough | Physician Assistant | 720 S Van Buren St Ste 301, Green Bay, WI 54301-3534 | 2011-10-12 |
| 1093942047 | Taresa B Fassbender | Physician Assistant | 3263 Eaton Rd Ste 1, Green Bay, WI 54311-6830 | 2009-06-17 |
| 1265628507 | Colleen M Van Egeren | Physician Assistant | 715 Superior Rd, Suite 120, Green Bay, WI 54311-7594 | 2007-09-20 |
| 1427079516 | Dermatology Clinic S.c. | Physician Assistant | 715 Superior Rd Ste 120, Green Bay, WI 54311-7595 | 2006-07-22 |
| 1316976814 | Kevin F Nelson | Physician Assistant | 3237 Voyager Dr, Green Bay, WI 54311-8349 | 2006-06-30 |
| 1841233186 | Randall R Southards | Physician Assistant | 2845 Greenbrier Rd Ste 320, Green Bay, WI 54311-6519 | 2006-06-14 |
| 1285684662 | Elaine M Smith | Physician Assistant | 301 Bay Park Sq, Green Bay, WI 54304-5104 | 2006-05-10 |
| Find all providers in GREEN BAY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.