Active NPI
Brannon Zochert, MS, LAT, ATC
- Athletic Trainer
- Pleasant Prairie, WI
National Provider Identifier
1821626268
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 2379-39
- Practice address
- 12616 104TH St
Pleasant Prairie, WI 53158-6100 - Phone
- (248) 762-1397
- NPI assigned
- Mar 31, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 2379-39 | WI | Primary |
Addresses
Primary practice location
12616 104TH St
Pleasant Prairie, WI 53158-6100
Mailing address
3335 Rock Ridge Rd
West Bend, WI 53095-7600
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2379-39 | WI | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1585612800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1614816000000",
"number": "1821626268",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3335 ROCK RIDGE RD",
"city": "WEST BEND",
"state": "WI",
"postal_code": "530957600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12616 104TH ST",
"city": "PLEASANT PRAIRIE",
"state": "WI",
"postal_code": "531586100",
"telephone_number": "248-762-1397"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZOCHERT",
"first_name": "BRANNON",
"credential": "MS, LAT, ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-03-31",
"last_updated": "2021-03-04",
"certification_date": "2021-03-04",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "WI",
"license": "2379-39",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pleasant Prairie, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.