Duffy David Eberhardt

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

Practice address

N7936 Woody LN
Ixonia, WI 53036-9479

Phone

(262) 510-8130

NPI assigned

May 9, 2018

Last updated

May 9, 2018By 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 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1525824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525824000000",
    "number": "1669961124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N7936 WOODY LN",
            "city": "IXONIA",
            "state": "WI",
            "postal_code": "530369479",
            "telephone_number": "262-510-8130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N7936 WOODY LN",
            "city": "IXONIA",
            "state": "WI",
            "postal_code": "530369479",
            "telephone_number": "262-510-8130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBERHARDT",
        "first_name": "DUFFY",
        "middle_name": "DAVID",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-09",
        "last_updated": "2018-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "146N00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medical Technician, Basic",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela Lynn Bubnick, RN
• Linda Olson Douglas, MD
• Jennifer Michele Gates
• Kim M Jaeger, LCSW SAC
• Amy L Lauersdorf, LPN
• Kerry Wayne Lynch, PH.D.
• Jessica M Nevermann, MS CCC-SLP

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2018; 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.