Individual provider Active NPI

Holly D Bruns, M.P.T.

  • Physical Therapist
  • Coeur D Alene, ID
National Provider Identifier
1033377155
Registry record updated May 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT-1878 Issued in ID
Practice address
500 W Aqua Ave
Coeur D Alene, ID 83815-7764
Phone
(208) 762-1122
NPI assigned
May 26, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT-1878 ID Primary
Physical Therapist 225100000X PT00007686 WA

Addresses

Primary practice location

500 W Aqua Ave
Coeur D Alene, ID 83815-7764

Mailing address

500 W Aqua Ave
Coeur D Alene, ID 83815-7764
Phone (208) 762-1122

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT-1878IDMDPhysical Therapist
PT00007686WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Physical Therapy and Sports Medicine, Inc Physical Therapist PastSince Apr 1, 2007 Accepting new patients
Summit Rehab Valley Corporation Physical Therapist Past Accepting new patients
Summit Rehabilitation Associates, PLLC Physical Therapist PastSince Aug 1, 2001 Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1211760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211760000000",
    "number": "1033377155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 W AQUA AVE",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838157764",
            "telephone_number": "208-762-1122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W AQUA AVE",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838157764",
            "telephone_number": "208-762-1122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNS",
        "first_name": "HOLLY",
        "middle_name": "D",
        "name_prefix": "Mrs.",
        "credential": "M.P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-26",
        "last_updated": "2008-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "PT-1878",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00007686",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coeur D Alene, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.