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Jackson Ryan Brunner , LAT, ATC

Specialist/Technologist - Athletic Trainer β€’ Normal, IL

Active NPI 1821563453 Individual Practitioner Male Practitioner
Practice location in NPPES

7160 Athletics Kaufman Football Building
Normal, IL 617906953

Call 3094380607 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

7160 Athletics Kaufman Football Building

Normal, IL 617906953

Telephone 3094380607

NPI first issued

2018

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Normal and Illinois

62 active clinicians are listed under Specialist/Technologist - Athletic Trainer with a practice address in Normal, IL (1,930 in Illinois).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Normal

0% of these 62 clinicians have the CMS telehealth indicator.

0% of these 62 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2021-09-28
Specialist/Technologist - Athletic Trainer Primary Specialty

NUCC Taxonomy Code: 2255A2300X

License # reported to NPPES IL 096.004944

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.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Illinois Department of Financial and Professional Regulation.
Look Up on State Board Site

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

11 Historical Events
πŸ“
Updated Practice Location September 28, 2021

Registered at 7160 ATHLETICS KAUFMAN FOOTBALL BUILDING, NORMAL, IL 617906953 (Tel: 3094380607)

πŸ“
Updated Business Mailing Address September 28, 2021

Registered at 7160 ATHLETICS KAUFMAN FOOTBALL BUILDING, NORMAL, IL 617900001

πŸ‘€
Provider Name / Credentials Updated September 28, 2021

Recorded as JACKSON BRUNNER, LAT, ATC

πŸ“
Updated Practice Location September 09, 2019

Registered at 1206 S 4TH ST, CHAMPAIGN, IL 618206953 (Tel: 2173008605)

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) September 09, 2019

Specialist/Technologist (license number reported to NPPES: IL 096.004944)

βœ…
NPI Profile Active October 10, 2018

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) October 10, 2018

Registered at 2196 S RAINWATER DR, DECATUR, IL 625214863 (Tel: 2178556136)

πŸ“
Business Mailing Address (Initial Record) October 10, 2018

Registered at 2196 S RAINWATER DR, DECATUR, IL 625214863

πŸ‘€
Provider Name / Credentials (Initial Record) October 10, 2018

Recorded as JACKSON BRUNNER

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) October 10, 2018

Specialist/Technologist

🟒
Initial NPI Registration & Enumeration October 10, 2018

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1821563453
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 10, 2018
Last Update: September 28, 2021
Sole Proprietor: No

Mailing Address

7160 Athletics Kaufman Football Building

Normal, IL 617900001

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.