1. Home
  2. Directory
  3. Missouri
  4. Bolivar
  5. Specialist Technologist
  6. NPI Profile

MR. BRANDT DERRICKSON ATC
NPI 1932650736
Specialist/Technologist - Athletic Trainer in Bolivar, MO

Active since October 18, 2016
1155 W PARKVIEW ST STE 2D, BOLIVAR, MO 65613(417) 777-2663(417) 326-2666 Get Directions Write a Review

NPPES record last updated: October 18, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mr. Brandt Derrickson Atc NPPES

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

MR. BRANDT DERRICKSON ATC (NPI 1932650736) is an individual athletic trainer provider in Bolivar, Missouri, licensed in Missouri (2016004534) and active in the NPI registry since October 2016.

NPPES Registry Identity

NPI1932650736
Entity TypeIndividualMale
Primary Taxonomy2255A2300X
Provider Legal NameMR. BRANDT DERRICKSONCredential: ATC
Location Address1155 W PARKVIEW ST STE 2DBolivar, MO 65613-7800
Mailing Address1500 N Oakland AveBolivar, MO 65613-3011 · (417) 326-6000 · Fax (417) 328-6338
Phone(417) 777-2663
Fax(417) 326-2666
Sole ProprietorNo
Enumeration DateOctober 18, 2016
✔ NPI 1932650736 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 MO · 2016004534
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.
1155 W PARKVIEW ST STE 2D, Bolivar, MO 65613
Open in Google Maps ↗

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. STEPHEN CRAIG MORRIS M.D.
Orthopaedic Surgery (Sports Medicine)
1155 W PARKVIEW ST STE 2D
BOLIVAR, MO 65613
Polk County (417) 777-2663

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 Brandt Derrickson's NPI number?

The NPI number for Brandt Derrickson is 1932650736. It was assigned to this individual provider in the NPPES registry on October 18, 2016.

Where is Brandt Derrickson located?

Brandt Derrickson practices at 1155 W Parkview St Ste 2D, Bolivar, MO 65613. The listed phone number is (417) 777-2663.

What is Brandt Derrickson'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 Brandt Derrickson was last updated on October 18, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.