MR. ROBERT W BRODDUS JR. (NPI# 1407203060) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407203060 |
| Entity Type | Individual |
| Full Name | MR. ROBERT W BRODDUS JR. |
| Credential | LAT, ATC |
| Practice Address |
1101 Camden Ave Salisbury University Salisbury MD 21801-6837 |
| Mailing Address |
124 Drexler Ave S Liverpool NY 13088-6634 |
| Practice Telephone | 4105436355 |
| Practice Fax Number | 4105462639 |
| Mailing Telephone | 3153828107 |
| Enumeration Date | 2016-05-24 |
| Last Update Date | 2016-05-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
A0000758 | MD | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
1101 CAMDEN AVE SALISBURY UNIVERSITY |
| City | SALISBURY |
| State | MD |
| Zip Code | 21801-6837 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376536722 | Patrick Michael Lamboni | Specialist/Technologist | 1101 Camden Ave, Salisbury University, Salisbury, MD 21801-6837 | 2005-08-31 |
| 1003448945 | Maiya Gibson | Specialist/Technologist | 1101 Camden Ave, Salisbury, MD 21801-6837 | 2020-02-09 |
| 1629612296 | Chloe Alexandra Cupernall | Student in an Organized Health Care Education/Training Program | 1101 Camden Ave, Salisbury, MD 21801-6837 | 2019-11-06 |
| 1003373739 | Donald Wayne Mathis | Specialist/Technologist | 1101 Camden Ave, Salisbury, MD 21801-6837 | 2019-02-28 |
| 1265997662 | Emma Rose Coard | Behavior Technician | 1101 Camden Ave, Salisbury, MD 21801-6837 | 2019-02-10 |
| 1619432614 | Lauren Whetzel | Specialist/Technologist | 1101 Camden Ave, Salisbury, MD 21801-6837 | 2019-02-04 |
| 1730697699 | Silvana Cespedes | Specialist/Technologist | 1101 Camden Ave, Salisbury, MD 21801-6837 | 2018-01-12 |
| 1427402502 | Michael Szymanski | Specialist/Technologist | 1101 Camden Ave, Salisbury, MD 21801-6837 | 2016-04-14 |
| 1003203209 | Nya Dobbs | Specialist/Technologist | 1101 Camden Ave, Salisbury, MD 21801-6837 | 2015-04-25 |
| 1386031748 | Max Owens | Specialist/Technologist | 1101 Camden Ave, Salisbury, MD 21801-6837 | 2015-04-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487263760 | Patricia Ann Nativio | Specialist/Technologist | University of Maryland University Eastern Shore, William P Hytche Athletic Center, Princess Anne, MD 21801 | 2020-07-23 |
| 1710516315 | Launa Duffy | Counselor | 1300 East Carroll St, Salisbury, MD 21801 | 2020-04-06 |
| 1275161960 | Zion Wellness Center | Psychiatry & Neurology | 2324 West Zion Road Unit 110, Salisbury, MD 21801 | 2020-03-30 |
| 1508404997 | Pridgett Harmon | Counselor | 2324 West Zion Road, Suite 112, Salisbury Md, MD 21801 | 2019-12-16 |
| 1821646324 | Diane Palmer | Counselor | 2324 West Zion Rd., Suit 112, Salisbury, MD 21801 | 2019-08-28 |
| 1558923672 | Oc Wellness LLC | Nurse Practitioner | 1410 S Salisbury Blvd Unit 1, Salisbury, MD 21801 | 2019-06-28 |
| 1033686670 | Megan Insley | Speech-Language Pathologist | 1213 Emeron Ave, Salisbury, MD 21801 | 2018-11-01 |
| 1811462831 | Kailyn Asbury | Registered Nurse | 100 E. Carroll St., Prmc Dept of Physical Medicine, Salisbury, MD 21801 | 2018-10-05 |
| 1750866380 | Marc Levin Mcdonald | Physical Therapist | 2420 North Salisbury Blvd Unit 5, Salisbury, MD 21801 | 2018-09-28 |
| 1891277695 | Lindsay Britt Stallings | Counselor | 116 West Main St. Suite 204, Salisbury, MD 21801 | 2018-08-29 |
| Find all providers in zip 21801 | ||||
| Taxonomy Code | 2255A2300X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Specialist/Technologist |
| Specialization | Athletic Trainer |
| Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-level employment requirements are a bachelor’s degree with a major in athletic training from an accredited university or college. A majority of athletic trainers hold advanced degrees. National board certification is generally required as a condition of state licensure and employment. Most states regulate athletic trainers, and they practice within the scope of that license or regulation. Clinical practice includes emergency care, rehabilitation, reconditioning, therapeutic exercise, wellness programs, exercise physiology, kinesiology, biomechanics, nutrition, psychology and health care administration. |
| Notes: Source: National Athletic Trainers’ Association (www.NATA.org) [1/1/2006: modified definition, modified source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558826263 | Samantha Jo Antosiewicz | Specialist/Technologist | 1324 Aspen Dr, Salisbury, MD 21804-2065 | 2019-02-06 |
| 1295226314 | Kelsey Tripp | Specialist/Technologist | 621 W Council St, Salisbury, NC 28144-4135 | 2018-05-24 |
| 1093216053 | Raheem Ramsey | Specialist/Technologist | 516 Emory Ct Apt 203, Salisbury, MD 21804-5295 | 2018-02-26 |
| 1801334974 | Vicente V. Demetri Rosette II | Specialist/Technologist | 1020 Adams Ave Apt 2c, Salisbury, MD 21804-6689 | 2017-02-08 |
| 1568830362 | Leane Blais | Specialist/Technologist | 836 Brookfield Cir, Salisbury, NC 28146-8534 | 2015-09-10 |
| 1982083978 | Kathy June Elliott | Specialist/Technologist | 3521 Saint Lukes Rd, Salisbury, MD 21804-1378 | 2015-05-22 |
| 1740676204 | Phil Liotta | Specialist/Technologist | 706 College Ln, Apt 12, Salisbury, MD 21804-9149 | 2015-04-11 |
| 1639565419 | Molly E Potvin | Specialist/Technologist | 1526 Anchors Way, Salisbury, MD 21801-7448 | 2015-04-08 |
| 1366841157 | Emily Wood | Specialist/Technologist | 502 Green Mor Ct, Apt 1, Salisbury, MD 21804-6206 | 2014-08-18 |
| 1720419906 | Dean Chaney Proctor | Specialist/Technologist | 1630 Airport Rd, Salisbury, NC 28147-8915 | 2013-12-12 |
| Find all providers in SALISBURY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.