MR. THOMAS PEPPER BURRUSS (NPI# 1881722072) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881722072 |
| Entity Type | Individual |
| Full Name | MR. THOMAS PEPPER BURRUSS |
| Credential | PT ATC |
| Practice Address |
1265 Lombardi Ave Green Bay WI 54304-3927 |
| Practice Telephone | 9205697500 |
| Practice Fax Number | 9205697803 |
| Mailing Telephone | 9205697500 |
| Mailing Fax Number | 9205697803 |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
1265 LOMBARDI AVE |
| City | GREEN BAY |
| State | WI |
| Zip Code | 54304-3927 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558377515 | Kurt Alan Fielding | Specialist/Technologist | 1265 Lombardi Ave, Green Bay, WI 54304-3927 | 2006-07-31 |
| 1437668134 | Steven Thomas Paul | Specialist/Technologist | 1265 Lombardi Ave, Green Bay, WI 54304-3927 | 2017-09-25 |
| 1093845133 | Bryan Eric Engel | Specialist/Technologist | 1265 Lombardi Ave, Green Bay, WI 54304-3927 | 2007-03-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689196255 | Kristen Ashley Haltom | Registered Nurse | 2979 Allied St Suite C, Green Bay, WI 54304 | 2017-07-14 |
| 1649671421 | Heather Marie Novak | Counselor | 2979 Allied St Unit C, Green Bay, WI 54304 | 2014-09-11 |
| 1356777684 | Nathan Weir | Specialist/Technologist | 1265 Lombardi Avenue, Green Bay, WI 54304 | 2013-09-18 |
| 1922349927 | John W Hartman | Internal Medicine | 916 Willard Dr, Suite 200, Green Bay, WI 54304 | 2013-03-15 |
| 1447551379 | Citralina M Haruo | Community Health Worker | 1110 11th Avenue, Green Bay, WI 54304 | 2010-11-09 |
| 1497061352 | Daniel James Gustin | Pharmacist | 1109 Lombardi Ave, Green Bay, WI 54304 | 2010-08-28 |
| 1316259898 | Karen A Detrick | Occupational Therapy Assistant | 1040 Pilgram Way, Woodside Senior Communities, Green Bay, WI 54304 | 2010-07-13 |
| 1861667362 | Planned Parenthood of Wi, Inc | Non-Pharmacy Dispensing Site | 2605 S. Oneida St. Suite 107, Green Bay, WI 54304 | 2008-04-25 |
| 1891967303 | Kimberley M Welk | Marriage & Family Therapist | 926 Willard Dr Ste 136, Green Bay, WI 54304 | 2008-03-25 |
| 1750563698 | Richard Lawrence Beyer | Hearing Instrument Specialist | 2154 S Ridge Rd, Green Bay, WI 54304 | 2007-12-03 |
| Find all providers in zip 54304 | ||||
| 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 |
|---|---|---|---|---|
| 1033774591 | Laura Snyder | Specialist/Technologist | 1356 Suburban Ave, Green Bay, WI 54304-3832 | 2019-05-09 |
| 1982193124 | Kevin William Cropsey | Specialist/Technologist | 3132 W Ottertail Ct, Green Bay, WI 54311-7608 | 2018-05-03 |
| 1144718511 | Kasi Marie Bardouche | Specialist/Technologist | 2884 Sussex Rd, Green Bay, WI 54311-7475 | 2018-05-01 |
| 1407359474 | Samantha Matuszak | Specialist/Technologist | 2944 Shefield Ct, Green Bay, WI 54311-5029 | 2018-03-15 |
| 1477094548 | Jenna Carter | Specialist/Technologist | 3181 Jaguar Ln, Green Bay, WI 54313-9236 | 2017-03-09 |
| 1699216788 | Meghan Lange | Specialist/Technologist | 1612 Royal Crown Ct, Green Bay, WI 54313-4390 | 2017-03-09 |
| 1619429479 | Wyatt O'neil | Specialist/Technologist | 3044 Warm Springs Dr, Green Bay, WI 54311-5030 | 2016-10-27 |
| 1770947640 | Brian Hanson | Specialist/Technologist | 234 Swiss Meadow Ln, Green Bay, WI 54302-5253 | 2016-04-07 |
| 1083092795 | Alena Rose Mcguire | Specialist/Technologist | 2717 Prairie Garden Trl, Green Bay, WI 54313-3958 | 2015-05-13 |
| 1467849307 | Maureen Riordan | Specialist/Technologist | 2957 S Telemark Cir., Green Bay, WI 54313 | 2015-04-17 |
| 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.