Nathan M Brine, ATC LAT

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

1005-39 Issued in WI

Practice address

2305 Willis Miller Dr
Hudson, WI 54016

Phone

(715) 386-1155

Fax

(715) 386-1105

NPI assigned

Jun 23, 2011

Last updated

Jun 23, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1308787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308787200000",
    "number": "1053607499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "483 COUNTRY VIEW RD",
            "city": "HUDSON",
            "state": "WI",
            "postal_code": "540167819",
            "telephone_number": "715-222-3847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2305 WILLIS MILLER DR",
            "city": "HUDSON",
            "state": "WI",
            "postal_code": "54016",
            "telephone_number": "715-386-1155",
            "fax_number": "715-386-1105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRINE",
        "first_name": "NATHAN",
        "middle_name": "M",
        "credential": "ATC LAT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-23",
        "last_updated": "2011-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "WI",
            "license": "1005-39",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brave Counseling and Coaching, PLLC
• Brdige for Hudson Youth, Inc. (Bridge for Youth with Disabilities)
• Mary J Breault, H.I.S
• Bryan Thomas Brettin, DDS, MS
• Randy L Briggs, OTR
• Kenneth R Brisson, DDS
• James Harold Broecker, MS, LMFT
• Michael Bruinooge, D.D.S.
• Jinger K Brulz, MSE CFY-SLP
• Laura Bryngelson

• Athletic Trainer in Hudson, WI
• Providers in Hudson, WI by specialty
• Athletic Trainer in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2011; 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.