DR. BRYAN R GERONDALE (NPI# 1598852147) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598852147 |
| Entity Type | Individual |
| Full Name | DR. BRYAN R GERONDALE |
| Credential | D.C. |
| Practice Address |
5306 N Port Washington Rd Glendale WI 53217-4913 |
| Practice Telephone | 4143320859 |
| Practice Fax Number | 4143323991 |
| Mailing Telephone | 4143320859 |
| Mailing Fax Number | 4143323991 |
| Enumeration Date | 2006-10-06 |
| Last Update Date | 2017-04-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 111N00000X | Chiropractor | 1776-12 | WI | Chiropractic Providers |
| Y | 111NS0005X |
Chiropractor Specialization: Sports Physician |
1776-012 | WI | Chiropractic Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 38776000 | 05 |
| Street Address |
5306 N PORT WASHINGTON RD |
| City | GLENDALE |
| State | WI |
| Zip Code | 53217-4913 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619074689 | Allen D Van Scoyk | Chiropractor | 5306 N Port Washington Rd, Glendale, WI 53217-4913 | 2006-09-20 |
| 1356977334 | Rachel Defnet | Chiropractor | 5306 N Port Washington Rd, Glendale, WI 53217-4913 | 2020-03-21 |
| 1578074225 | Mina Botros | Chiropractor | 5306 N Port Washington Rd, Glendale, WI 53217-4913 | 2017-10-21 |
| 1922302231 | Nicholas Hellenbrand | Chiropractor | 5306 N Port Washington Rd, Glendale, WI 53217-4913 | 2010-12-29 |
| 1972667913 | Chiropractic Company S.c. | Chiropractor | 5306 N Port Washington Rd, Glendale, WI 53217-4913 | 2006-12-21 |
| 1841387479 | Michael J Kaminski | Chiropractor | 5306 N Port Washington Rd, Glendale, WI 53217-4913 | 2006-10-06 |
| 1700970266 | Tina M Mcleod | Chiropractor | 5306 N Port Washington Rd, Glendale, WI 53217 | 2006-10-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922632587 | Jasmine Dockery | Pharmacist | 5400 N Port Washington, Glendale, WI 53217 | 2020-02-23 |
| 1174017339 | North Lakes Nursing Home Health Care Agency LLC | Home Health | 225 E Fairmount Ave, Milwaukee, WI 53217 | 2018-06-20 |
| 1083140289 | Miriah Ann King, Ms, Lpc | Counselor | 7805 North Boyd Way, Fox Point, WI 53217 | 2017-05-08 |
| 1245783067 | Lakesha L Jones | Counselor | 5235 N Ironwood Rd, Glendale, WI 53217 | 2016-07-28 |
| 1750783312 | Ibrahim S Abouzeid | Specialist/Technologist, Other | 333 W Brown Deer Road, #240, Milwaukee, WI 53217 | 2014-09-25 |
| 1255733598 | Victoria Gorodetsky | Pharmacist | 229 W Indian Creek Ct, Milwaukee, WI 53217 | 2014-09-18 |
| 1174800049 | John Herman Esser | Internal Medicine | 1050 W Acacia Rd, Milwaukee, WI 53217 | 2011-11-07 |
| 1710298351 | Leann M Harman | Physical Therapist | 5333 N Port Washington Rd Ste B, Glendale, WI 53217 | 2010-06-29 |
| 1306012455 | Emily Marie Gallagher | Speech-Language Pathologist | 6700 N. Port Washington Road, Milwaukee, WI 53217 | 2008-05-07 |
| 1164625455 | Mary Catherine Enderlin | Psychologist | 6110 N Port Washington Road, The Cambridge Group, Glendale, WI 53217 | 2007-06-06 |
| Find all providers in zip 53217 | ||||
| Taxonomy Code | 111NS0005X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| Specialization | Sports Physician |
| A sports chiropractor is uniquely trained to provide care and treatment of injuries or illness resulting from sports and physical fitness activities. Doctors of Chiropractic with the Diplomate American Chiropractic Board of Sports Physicians (DACBSP) or the Certified Chiropractic Sports Physician (CCSP), sport specialty certifications from the American Chiropractic Board of Sports Physicians, have advanced training in the assessment, management and rehabilitation of sports related injuries. Extremity care, rehabilitation and soft tissue procedures are common skills utilized by these doctors. The specialty training covers a broad spectrum from the pediatric athlete to professional and Olympic athletes, and everything in between, using a variety of techniques and modalities. |
| Notes: Source: American Chiropractic Board of Sports Physicians, 2009 [7/1/2009: definition added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316451453 | Cru Cyler Moore | Chiropractor | 1525 Broadview Dr, Glendale, CA 91208-1226 | 2017-11-28 |
| 1043409832 | Ryan Austin Tuchscherer | Chiropractor | 400 S Colorado Blvd Ste 300, Glendale, CO 80246-1238 | 2007-10-17 |
| 1497833636 | Corey James Schneider | Chiropractor | 5261 N Port Washington Rd, Suite 101, Glendale, WI 53217-4903 | 2006-11-02 |
| 1134239361 | Bruce A Jacobs | Chiropractor | 3510 1/2 Ocean View Blvd, Glendale, CA 91208-1285 | 2006-08-30 |
| 1013107200 | Joseph K. Merdkhanian D.c. Inc. | Chiropractor | 1030 S Glendale Ave Ste 401, Glendale, CA 91205-2866 | 2007-07-25 |
| 1508056797 | Joseph Kevork Merdkhanian | Chiropractor | 1030 S Glendale Ave Ste 401, Glendale, CA 91205-2866 | 2007-07-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346658903 | Winneconne Chiropractic and Sports Rehab LLC | Chiropractor | 238 W Main Street, Winneconne, WI 54986 | 2014-07-28 |
| 1760727937 | Frederick Knight Sheppard | Chiropractor | 2649 Bay Settlement Rd, Green Bay, WI 54311-7328 | 2012-11-29 |
| 1306102066 | Imagine Chiropractic and Wellness Center, Inc. | Chiropractor | 445 Cardinal Ln Ste 110, Green Bay, WI 54313-9577 | 2012-04-06 |
| 1609146182 | Grace E Zuiker Nash | Chiropractor | 5829 Birch Ln, Rhinelander, WI 54501-8986 | 2011-12-30 |
| 1477724276 | Washa Chiropractic Clinic, Inc. | Chiropractor | 1415 State Road 16, La Crosse, WI 54601-2980 | 2008-03-19 |
| 1235318585 | Newcare Integrated Health Services, S.c. | Chiropractor | 1366 Appleton Rd, Suite A, Menasha, WI 54952-1504 | 2007-11-02 |
| 1114126570 | Jay J Meverden | Chiropractor | 2600 Stewart Ave Ste 154, Wausau, WI 54401-1404 | 2007-07-16 |
| 1679785729 | Twit Chiropractic Clinic, S.c. | Chiropractor | 3125 Main Street, Stevens Point, WI 54481 | 2007-05-03 |
| 1750507885 | Taylor Chiropractic & Sports Injury Center, S.c. | Chiropractor | 153 E Jefferson St, Spring Green, WI 53588 | 2007-04-17 |
| 1851425052 | William E Atkinson | Chiropractor | 1344 Creston Park Dr, Janesville, WI 53545-1113 | 2007-03-16 |
| Find all providers with the same taxonomy | ||||
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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.