Carson Matthew Bruner

Primary specialty

OptometristTaxonomy code 152W00000X

License

7159 Issued in OH

Practice address

201 S 2ND St
Coldwater, OH 45828-1747

Phone

(937) 417-4581

NPI assigned

Apr 5, 2023

Last updated

Jul 17, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dickman Kettler and Bruner IncGroup PAC ID 1759380694, 6 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Dickman Kettler & Bruner Inc

  • Optometrist
  • Coldwater, OH
  • NPI 1558478453
  Medicare reassignment Care Compare group NPD
• Northwest Optometry LLC

  • Optometrist
  • Englewood, OH
  • NPI 1316004187
  NPD (past)

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

{
    "created_epoch": "1680652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689552000000",
    "number": "1063107183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6050 ANNA M AVE",
            "city": "GREENVILLE",
            "state": "OH",
            "postal_code": "453319609",
            "telephone_number": "937-417-4581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 S 2ND ST",
            "city": "COLDWATER",
            "state": "OH",
            "postal_code": "458281747",
            "telephone_number": "937-417-4581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNER",
        "first_name": "CARSON",
        "middle_name": "MATTHEW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-04-05",
        "last_updated": "2023-07-17",
        "certification_date": "2023-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "7159",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer R Bills, CPNP
• Valerie Blasingame, D.C.
• Jacquelyn Broering, PT
• Claire Elizabeth Brown, LSW
• Amy Bruggeman
• Jillynn F Bruner, OD
• Brunet Dental LLC
• Veronica L Brunet, DDS
• Michael Joseph Bruns, DDS
• Kathryn Burke, OTR/L

• Optometrist in Coldwater, OH
• Providers in Coldwater, OH by specialty
• Optometrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.