Kasey Trunk

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

2101-39 Issued in WI

Practice address

W892 Hwy 96
Kaukauna, WI 54130

Phone

(920) 809-8159

NPI assigned

Sep 18, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Kasey Ederer Former name

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": "1442534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548806400000",
    "number": "1194194209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 E FLORIDA AVE",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549111327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W892 HWY 96",
            "city": "KAUKAUNA",
            "state": "WI",
            "postal_code": "54130",
            "telephone_number": "920-809-8159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRUNK",
        "first_name": "KASEY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-18",
        "last_updated": "2019-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "WI",
            "license": "2101-39",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "WI",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KASEY",
            "last_name": "EDERER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jenna Lelsey Sullivan, OD
• Sunrise Care Homes
• Karen Teutschmann
• Gaosheng Thao
• The Doc at Your Door,LLC
• Jessica Jo Van Schyndel, OTR
• Kathleen S Van Zeeland, MS,CCC-SLP
• Molly Vande Wettering
• Travis Edward Vanden Heuvel, LPN
• David G Vanderloop II, O.D.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2019; 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.