Jennifer E Bruyere, BA, AAS, RT(R)(M)

Primary specialty

Radiologic TechnologistTaxonomy code 247100000X

License

373912 Issued in MN

Practice address

4235 32ND Ave S
Minneapolis, MN 55406-3315

Phone

(612) 729-2205

NPI assigned

Nov 26, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Ms. Jennifer Ann Edwards Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Associate of Applied Science, Bachelor of Arts

State licenses

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

{
    "created_epoch": "1353888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353888000000",
    "number": "1033453303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4235 32ND AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554063315",
            "telephone_number": "612-729-2205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4235 32ND AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554063315",
            "telephone_number": "612-729-2205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUYERE",
        "first_name": "JENNIFER",
        "middle_name": "E",
        "name_prefix": "Mrs.",
        "credential": "BA, AAS, RT(R)(M)",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-26",
        "last_updated": "2012-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "247100000X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist",
            "state": "MN",
            "license": "373912",
            "primary": true
        },
        {
            "code": "2471M2300X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Mammography",
            "state": "MN",
            "license": "373912",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IEMA DIVISION OF NUCLEAR SAFETY",
            "identifier": "500506806",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN REGISTRY OF RADIOLOGIC TECHNOLOGISTS",
            "identifier": "373912",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "EDWARDS",
            "middle_name": "ANN",
            "prefix": "MS.",
            "credential": "BA, AAS, RT(R)(M)",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Olga G Brusilovsky, RD,LD
• Thomas Del Bruss, DDS
• Jordan Brust
• Matthew David Brusven
• Ryan Brutger, DPT
• Amy Katherine Bruzek, MD
• Alexander D Bryan, MD
• Laura Jane Bryan, RN
• Samantha Bryan, DO
• Sara Ann Bryan, CPNP

• Radiologic Technologist in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Radiologic Technologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2012; 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.