BRENT P KOMLOFSKE (NPI# 1811455462) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811455462 |
| Entity Type | Individual |
| Full Name | BRENT P KOMLOFSKE |
| Credential | ATC, LAT |
| Practice Address |
1008 Jerry Mashek Dr West TX 76691-1866 |
| Mailing Address |
4500 N Ibp Rd Holcomb KS 67851-9023 |
| Practice Telephone | 2549812050 |
| Practice Fax Number | 2548267514 |
| Mailing Telephone | 6206407924 |
| Enumeration Date | 2019-03-03 |
| Last Update Date | 2019-03-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
AT7233 | TX | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 50 Hillcrest Medical Blvd Ste 303, Waco, TX 767128955 | 2547411400 |
| Street Address |
1008 JERRY MASHEK DR |
| City | WEST |
| State | TX |
| Zip Code | 76691-1866 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194243667 | Lauren Nicole Wernet | Specialist/Technologist | 305 Vardiman Rd, West, TX 76691 | 2017-09-05 |
| 1952433310 | P S Well-child Clinic | Family Medicine | 407 W Oak St., West, TX 76691 | 2007-03-12 |
| 1154467934 | Dr Walter J Mellgren Jr Dc Pa | Chiropractor | 109 N Regan St, West, TX 76691 | 2007-01-29 |
| 1093878092 | West Station Enterprise Inc | Durable Medical Equipment & Medical Supplies | 1579 Tokio Rd, West, TX 76691 | 2006-12-19 |
| 1790897601 | Generation Rx Inc. | Durable Medical Equipment & Medical Supplies | 206 N Main St, West, TX 76691 | 2006-08-31 |
| 1962416487 | Billy Don Pierce | General Practice | 407 W Oak St, West, TX 76691 | 2006-07-28 |
| 1891727004 | Avery Kirk Wines | Pharmacist | 200 N Main, West, TX 76691 | 2006-07-07 |
| 1083725816 | Paula Ann Snokhous | Physician Assistant | 407 W Oak St, West, TX 76691 | 2006-08-31 |
| 1558469312 | Larry D Sparks | Dentist | 312 N Main, West, TX 76691-0369 | 2006-09-20 |
| 1386675262 | Walter Jean Mellgren Jr. | Chiropractor | 109 N Reagan St, West, TX 76691-0475 | 2006-07-06 |
| Find all providers in zip 76691 | ||||
| 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 |
|---|---|---|---|---|
| 1710489216 | Jill Anne Davis | Specialist/Technologist | 290 Bolton Cir, West, TX 76691-2286 | 2018-03-01 |
| 1194243667 | Lauren Nicole Wernet | Specialist/Technologist | 305 Vardiman Rd, West, TX 76691 | 2017-09-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255932562 | Kyndall Leigh Soukup | Specialist/Technologist | 16002 Rosethorn Ct, Cypress, TX 77429-3490 | 2020-11-03 |
| 1447850631 | Claire Oliver-dehaven | Specialist/Technologist | 7012 Ridgetop Rd, North Richland Hills, TX 76182-3331 | 2020-10-28 |
| 1609476894 | Tessa Mcelroy | Specialist/Technologist | 1606 Trail Glen Ct, Pantego, TX 76013-3152 | 2020-10-28 |
| 1265031702 | Kiana Angelique Leveston | Specialist/Technologist | 2820 W Frey St Apt 7209, Stephenville, TX 76401-1905 | 2020-10-24 |
| 1205435856 | Jessica Moreno | Specialist/Technologist | 3718 Duck Creek Dr, Garland, TX 75043-2962 | 2020-10-23 |
| 1437758612 | Dina Y Scott | Specialist/Technologist | 107 N Greenville Ave Ste B, Allen, TX 75002-9161 | 2020-10-20 |
| 1275131864 | Kasie Bell | Specialist/Technologist | 215 Richland Dr, Kilgore, TX 75662-2049 | 2020-10-15 |
| 1184222663 | Zachary Mitchell Kimo Mitsui | Specialist/Technologist | 7311 Bluestone Rd, San Antonio, TX 78249 | 2020-10-15 |
| 1538766191 | Francisco Ruben Perez | Specialist/Technologist | 2503 6th St, Lubbock, TX 79409-9806 | 2020-10-07 |
| 1356958128 | Brandi Neeley | Specialist/Technologist | 12131 Kirby Dr, Houston, TX 77045-4857 | 2020-09-25 |
| Find all providers with the same taxonomy | ||||
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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.