Justin Broy, ATC, LAT

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

110868 Issued in IA

Practice address

1800 Admiral Sheehy Dr
Dubuque, IA 52001-2379

Phone

(563) 583-4949

NPI assigned

Sep 25, 2021

Sex

Male

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

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1632528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632528000000",
    "number": "1881365153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3410 ROUTE 5 W",
            "city": "HAZEL GREEN",
            "state": "WI",
            "postal_code": "538119700",
            "telephone_number": "207-318-6229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 ADMIRAL SHEEHY DR",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520012379",
            "telephone_number": "563-583-4949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROY",
        "first_name": "JUSTIN",
        "credential": "ATC, LAT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-09-25",
        "last_updated": "2021-09-25",
        "certification_date": "2021-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IA",
            "license": "110868",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Scott A Brock, M.D.
• Tara Lynn Brock, D.P.M.
• Nicole Broghammer, MA CCC-SLP
• Caroline Brondyke, OTD, OTR/L
• Ethan Brown
• Joshua Bruner, P.T, D.P.T
• Carson Michael Buck
• Jodi Lynn Bunge, PT
• Virginia Dawn Burdine, MD
• Christine Marie Burds, A.R.N.P.

• Athletic Trainer in Dubuque, IA
• Providers in Dubuque, IA by specialty
• Athletic Trainer in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 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.

Verify at the official NPI Registry.