DUFFY DAVID EBERHARDT (NPI# 1669961124) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669961124 |
| Entity Type | Individual |
| Full Name | DUFFY DAVID EBERHARDT |
| Practice Address |
N7936 Woody Ln Ixonia WI 53036-9479 |
| Practice Telephone | 2625108130 |
| Mailing Telephone | 2625108130 |
| Enumeration Date | 2018-05-09 |
| Last Update Date | 2018-05-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 146N00000X | Emergency Medical Technician, Basic | Emergency Medical Service Providers | ||
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
N7936 WOODY LN |
| City | IXONIA |
| State | WI |
| Zip Code | 53036-9479 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043239676 | Kerry Wayne Lynch | Psychologist | 8380 North St., Ixonia, WI 53036 | 2006-07-18 |
| 1003458472 | Angela Lynn Bubnick | Registered Nurse | W1011 Hunter Ln, Ixonia, WI 53036-9482 | 2019-10-17 |
| 1538110515 | Linda Olson Douglas | Family Medicine | W1046 Marietta Ave, Suite 230, Ixonia, WI 53036-9498 | 2006-05-13 |
| 1033398664 | Watertown Regional Medical Center Inc | Family Medicine | W1046 Marietta Ave, Ste 230, Ixonia, WI 53036-9498 | 2007-10-31 |
| 1851797070 | Kim Michele Jaeger | Counselor | N372 Lincoln Rd, Ixonia, WI 53036-9508 | 2014-11-16 |
| 1730133299 | Town of Ixonia | Ambulance | N8320 North St, Ixonia, WI 53036-9710 | 2006-05-20 |
| 1376956367 | Jennifer Michele Gates | Licensed Practical Nurse | W2093 Gary Ln, Ixonia, WI 53036-9724 | 2014-06-06 |
| 1215476874 | Beth Marie Pape | Registered Nurse | N8832 Leiger Ln, Ixonia, WI 53036-9726 | 2017-02-15 |
| 1598925992 | Amy L Lauersdorf | Licensed Practical Nurse | N9163 Ski Slide Rd, Ixonia, WI 53036-9767 | 2008-06-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003458472 | Angela Lynn Bubnick | Registered Nurse | W1011 Hunter Ln, Ixonia, WI 53036-9482 | 2019-10-17 |
| 1215476874 | Beth Marie Pape | Registered Nurse | N8832 Leiger Ln, Ixonia, WI 53036-9726 | 2017-02-15 |
| 1851797070 | Kim Michele Jaeger | Counselor | N372 Lincoln Rd, Ixonia, WI 53036-9508 | 2014-11-16 |
| 1376956367 | Jennifer Michele Gates | Licensed Practical Nurse | W2093 Gary Ln, Ixonia, WI 53036-9724 | 2014-06-06 |
| 1598925992 | Amy L Lauersdorf | Licensed Practical Nurse | N9163 Ski Slide Rd, Ixonia, WI 53036-9767 | 2008-06-10 |
| 1043239676 | Kerry Wayne Lynch | Psychologist | 8380 North St., Ixonia, WI 53036 | 2006-07-18 |
| 1730133299 | Town of Ixonia | Ambulance | N8320 North St, Ixonia, WI 53036-9710 | 2006-05-20 |
| 1538110515 | Linda Olson Douglas | Family Medicine | W1046 Marietta Ave, Suite 230, Ixonia, WI 53036-9498 | 2006-05-13 |
| 1033398664 | Watertown Regional Medical Center Inc | Family Medicine | W1046 Marietta Ave, Ste 230, Ixonia, WI 53036-9498 | 2007-10-31 |
| 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 |
|---|---|---|---|---|
| 1427657329 | Tyler John Friis | Specialist/Technologist | 1514 E Keystone Ln, Appleton, WI 54913-7162 | 2020-10-21 |
| 1184222085 | Ryan James Mcnamara | Specialist/Technologist | 28914 Golden Cir, Waterford, WI 53185-1197 | 2020-10-13 |
| 1770198699 | Tanner Sterling | Specialist/Technologist | 2538 E Garrison Rd, Foxboro, WI 54836-9507 | 2020-09-09 |
| 1922626670 | Eric William Brostrom | Specialist/Technologist | 3305 Lilly Rd, Brookfield, WI 53005-7608 | 2020-07-09 |
| 1174146690 | Brycen Valiga | Specialist/Technologist | 4477 S 113th St, Greenfield, WI 53228-2566 | 2020-05-19 |
| 1104448307 | Xeing Randy Yang | Specialist/Technologist | 2207 Namekagon St, Hudson, WI 54016-9426 | 2020-05-11 |
| 1073134615 | Brian Wood | Specialist/Technologist | 1950 Washington St, Grafton, WI 53024-2103 | 2020-05-06 |
| 1124649751 | Cody Scott Tesch | Specialist/Technologist | 6680 N Teutonia Ave, Milwaukee, WI 53209-3117 | 2020-05-05 |
| 1659992642 | Kelley Potila | Specialist/Technologist | 255 Maggilu Ct, Jefferson, WI 53549-2095 | 2020-04-30 |
| 1366070708 | Claire Duwell | Specialist/Technologist | 9111 W Bluemound Rd, Milwaukee, WI 53226-4506 | 2020-03-31 |
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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.