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JACKSON RYAN BRUNNER LAT, ATC
NPI 1821563453
Specialist/Technologist - Athletic Trainer in Normal, IL

Active since October 10, 2018
7160 ATHLETICS KAUFMAN FOOTBALL BUILDING, NORMAL, IL 61790(309) 438-0607 Get Directions Write a Review

NPPES record last updated: September 28, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 28, 2021, Sep 9, 2019, Oct 10, 2018 (3 updates tracked since 2018).

About Jackson Ryan Brunner Lat, Atc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACKSON RYAN BRUNNER LAT, ATC (NPI 1821563453) is an individual athletic trainer provider in Normal, Illinois, licensed in Illinois (096.004944) and active in the NPI registry since October 2018.

NPPES Registry Identity

NPI1821563453
Entity TypeIndividualMale
Primary Taxonomy2255A2300X
Provider Legal NameJACKSON RYAN BRUNNERCredential: LAT, ATC
Location Address7160 ATHLETICS KAUFMAN FOOTBALL BUILDINGNormal, IL 61790-6953
Mailing Address7160 Athletics Kaufman Football BuildingNormal, IL 61790-0001
Phone(309) 438-0607
Sole ProprietorNo
Enumeration DateOctober 10, 2018
Last NPPES UpdateSeptember 28, 20213 updates tracked since enumeration
NPPES CertifiedSeptember 28, 2021
✔ NPI 1821563453 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialist/Technologist · Athletic TrainerRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code2255A2300X
License✔ Licensed in IL · 096.004944
Definition
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.
7160 ATHLETICS KAUFMAN FOOTBALL BUILDING, Normal, IL 61790
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jackson Brunner's NPI number?

The NPI number for Jackson Brunner is 1821563453. It was assigned to this individual provider in the NPPES registry on October 10, 2018.

Where is Jackson Brunner located?

Jackson Brunner practices at 7160 Athletics Kaufman Football Building, Normal, IL 61790. The listed phone number is (309) 438-0607.

What is Jackson Brunner's specialty?

The primary specialty registered for this NPI is Specialist/Technologist, specializing in Athletic Trainer, with taxonomy code 2255A2300X.

When was this NPI record last updated?

The NPPES record for Jackson Brunner was last updated on September 28, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.