Jessica Ann Brundage, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

Practice address

5000 W National Ave
Zablocki Vamc-Spinal Cord Injury-128
Milwaukee, WI 53295-0001

Phone

(414) 384-2000

Fax

(414) 382-5293

NPI assigned

Jun 25, 2010

Sex

Female

Sole proprietor

Yes

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

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1277424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357516800000",
    "number": "1346551298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 W NATIONAL AVE",
            "address_2": "ZABLOCKI VAMC-SPINAL CORD INJURY SERVICE-128",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532950001",
            "telephone_number": "414-384-2000",
            "fax_number": "414-382-5293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 W NATIONAL AVE",
            "address_2": "ZABLOCKI VAMC-SPINAL CORD INJURY-128",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532950001",
            "telephone_number": "414-384-2000",
            "fax_number": "414-382-5293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNDAGE",
        "first_name": "JESSICA",
        "middle_name": "ANN",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-25",
        "last_updated": "2013-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keanna Brumfield
• Tytiana Monquie Brumley
• Jessica Lynn Brumm-Larson, PHD, LPC, NCSP
• Jennifer Brumm-Maciejewski
• Charles F Brummitt, M.D.
• Thomas Stephen Brundage
• Cynthia R Brune, MS ART THERAPY
• Kayla Brunette
• Patricia Marie Brunette, R.N.
• Tricia Brunmeier, N.P.

• Psychologist in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Psychologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.