Individual provider Active NPI

Andrew Braun, LAT, CSCS, CES

  • Rehabilitation Practitioner
  • Appleton, WI
National Provider Identifier
1013396472
Registry record updated May 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation PractitionerTaxonomy code 225400000X
License
1145-39 Issued in WI
Practice address
101 W Edison Ave
Suite 110
Appleton, WI 54915-1367
Phone
(920) 209-1662
NPI assigned
May 19, 2015
Last updated
May 19, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 19, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Practitioner 225400000X 1145-39 WI Primary

Addresses

Primary practice location

101 W Edison Ave
Suite 110
Appleton, WI 54915-1367

Mailing address

101 W Edison Ave
Suite 110
Appleton, WI 54915-1367
Phone (920) 209-1662

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

State licenses

LicenseStateTypeSpecialty
1145-39WIMDRehabilitation Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Movement Studio Past Accepting new patients
Advanced Movement Studio, LLC Rehabilitation Practitioner PastSince Apr 6, 2015 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1431993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431993600000",
    "number": "1013396472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 W EDISON AVE",
            "address_2": "SUITE 110",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549151367",
            "telephone_number": "920-209-1662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 W EDISON AVE",
            "address_2": "SUITE 110",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549151367",
            "telephone_number": "920-209-1662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAUN",
        "first_name": "ANDREW",
        "name_prefix": "Mr.",
        "credential": "LAT, CSCS, CES",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-05-19",
        "last_updated": "2015-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": "WI",
            "license": "1145-39",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Appleton, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.