Active NPI
John M Bruening
- Optician
- Middlefield, OH
National Provider Identifier
1043060288
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- OP.003884-SC
- Practice address
- 14894 N State Ave
Middlefield, OH 44062-9724 - Phone
- (440) 632-1695
- NPI assigned
- Mar 22, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician | 156FX1800X | OP.003884-SC | OH | Primary |
Addresses
Primary practice location
14894 N State Ave
Middlefield, OH 44062-9724
Mailing address
14894 N State Ave
Middlefield, OH 44062-9724
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OP.003884-SC | OH | MD | Optician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| My Optix Inc | Optician | Current | Accepting new patients |
Locations
14894 N State Ave
Middlefield, OH 44062
Phone (440) 632-1695
Organizations & group practices 1
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": "1711065600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1711065600000",
"number": "1043060288",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14894 N STATE AVE",
"city": "MIDDLEFIELD",
"state": "OH",
"postal_code": "440629724"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14894 N STATE AVE",
"city": "MIDDLEFIELD",
"state": "OH",
"postal_code": "440629724",
"telephone_number": "440-632-1695"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRUENING",
"first_name": "JOHN",
"middle_name": "M",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-03-22",
"last_updated": "2024-03-22",
"certification_date": "2024-03-22",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "OH",
"license": "OP.003884-SC",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Middlefield, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.