JACKY BRENTON (NPI# 1699381244) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699381244 |
| Entity Type | Individual |
| Full Name | JACKY BRENTON |
| Credential | ATC |
| Practice Address |
3676 Parker Blvd Ste 310 Pueblo CO 81008-2214 |
| Mailing Address |
Po Box 8066 Pueblo CO 81008 |
| Practice Telephone | 7195957780 |
| Mailing Telephone | 7192895809 |
| Enumeration Date | 2020-09-18 |
| Last Update Date | 2020-09-18 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
AT.0001926 | CO | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
3676 PARKER BLVD STE 310 |
| City | PUEBLO |
| State | CO |
| Zip Code | 81008-2214 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164058913 | Healthone Clinic Services - Oncology Hematology LLC | Internal Medicine | 3678 Parker Blvd, Pueblo, CO 81008 | 2020-03-12 |
| 1073026423 | Carmel Community Living Corporation | Respite Care | 2003 Northmoor Terrace, Suite 100, Pueblo, CO 81008 | 2017-11-08 |
| 1568987121 | Hannah Vivian Roadruck | Pharmacist | 4200 Dillon Dr., Pueblo, CO 81008 | 2017-08-04 |
| 1184170425 | Brett Burana | Dentist | 729 Us-50, Pueblo, CO 81008 | 2016-08-28 |
| 1760832885 | Irby Dental Cottage | Dental Hygienist | 2099 West St # 50, Suite 180, Pueblo, CO 81008 | 2016-06-20 |
| 1649624362 | Curley Peak Dentistry Pllc | Dentist | 1640 W Fortino Blvd, Pueblo, CO 81008 | 2016-04-19 |
| 1336507847 | Kyle Tipton | Nurse Anesthetist, Certified Registered | 4741 Eagleridge Circle, 206, Pueblo, CO 81008 | 2016-01-29 |
| 1407211931 | Center At Park West, LLC | Skilled Nursing Facility | 3727 Parker Blvd., Pueblo, CO 81008 | 2015-12-29 |
| 1417327461 | Nicole Betts | Registered Nurse | 1310 Fortino Blvd Ste D, Pueblo, CO 81008 | 2015-10-02 |
| 1437578028 | Pueblo Modern Dentistry and Orthodontics, LLP | Dentist | 727 Us Hwy 50 West, Pueblo, CO 81008 | 2014-04-10 |
| Find all providers in zip 81008 | ||||
| Taxonomy Code | 2255A2300X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Specialist/Technologist |
| Specialization | Athletic Trainer |
| Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-level employment requirements are a bachelor’s degree with a major in athletic training from an accredited university or college. A majority of athletic trainers hold advanced degrees. National board certification is generally required as a condition of state licensure and employment. Most states regulate athletic trainers, and they practice within the scope of that license or regulation. Clinical practice includes emergency care, rehabilitation, reconditioning, therapeutic exercise, wellness programs, exercise physiology, kinesiology, biomechanics, nutrition, psychology and health care administration. |
| Notes: Source: National Athletic Trainers’ Association (www.NATA.org) [1/1/2006: modified definition, modified source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124629357 | Brianna Jo Markowski | Specialist/Technologist | 99 Cornell Cir, Pueblo, CO 81005-1645 | 2020-11-04 |
| 1376142703 | Jose Mariscal | Specialist/Technologist | 1817 Yakima Ln, Pueblo, CO 81001-1513 | 2020-10-16 |
| 1316415474 | Codi N Vigil | Specialist/Technologist | 1303 Gray Wolf Cir, Pueblo, CO 81001-4931 | 2018-11-07 |
| 1891214557 | Mary Kathryn Martinez | Specialist/Technologist | 1801 Hollywood Dr, Pueblo, CO 81005-2511 | 2017-09-13 |
| 1518345917 | Devin Hart | Specialist/Technologist | 2900 Cascade Ave, Pueblo, CO 81008-1240 | 2015-05-18 |
| 1669872594 | Blake Pollema | Specialist/Technologist | 1337 Gray Wolf Cir, Pueblo, CO 81001-4932 | 2014-08-28 |
| 1346663226 | Brittany Hoover | Specialist/Technologist | 216 E Orman Ave, Pueblo, CO 81004-2144 | 2014-01-28 |
| 1538760533 | Angelica Nava | Specialist/Technologist | 2200 Bonforte Blvd, Pueblo, CO 81001-4901 | 2020-11-05 |
| 1023667268 | Shelby Bley | Specialist/Technologist | 1050 35th Ln, Pueblo, CO 81006-9426 | 2019-09-10 |
| 1689229718 | Christina Marie Shepard | Specialist/Technologist | 2200 Bonforte Blvd, Pueblo, CO 81001-4901 | 2019-08-06 |
| Find all providers in PUEBLO | ||||
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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.