Thomas M Brundage, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

106726 Issued in MO

Practice address

1002 Diamond RDG Ste 800
Jefferson City, MO 65109-7906

Phone

(573) 761-9360

Fax

(573) 761-9362

NPI assigned

Jul 26, 2006

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": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426636800000",
    "number": "1477577500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 BERRYWOOD DR",
            "address_2": "SUITE 204",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652016517",
            "telephone_number": "573-449-8771",
            "fax_number": "573-449-6563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1002 DIAMOND RDG STE 800",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651097906",
            "telephone_number": "573-761-9360",
            "fax_number": "573-761-9362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNDAGE",
        "first_name": "THOMAS",
        "middle_name": "M",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2015-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MO",
            "license": "106726",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donna Brown
• Katherine Brown
• Latoya Brown, MAADC II
• Matthew Elijah Brown, LCSW
• Holly Bruemmer, RD, LD
• Cory Rene Brune, DO
• Theresa Lynn Brune, O.T.
• Lisa Marie Bruns
• Bryan M. Pope, DDS Inc.
• Sunny Buchler, DO

• Athletic Trainer in Jefferson City, MO
• Providers in Jefferson City, MO by specialty
• Athletic Trainer in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 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.