Individual provider Active NPI

Michael Todd Bruner, D.C.

  • Chiropractor
  • Connellsville, PA
National Provider Identifier
1063590768
Registry record updated Sep 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC-006118-L Issued in PA
Practice address
420 W Crawford Ave
Connellsville, PA 15425-3031
Phone
(724) 628-8872
NPI assigned
Nov 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC-006118-L PA Primary

Addresses

Primary practice location

420 W Crawford Ave
Connellsville, PA 15425-3031

Mailing address

420 W Crawford Ave
Connellsville, PA 15425-3031
Phone (724) 628-8872

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051019000258 PA Practitioner - Chiropractic 3173549144 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

420 W Crawford Ave
Connellsville, PA 15425-3031

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC-006118-LPAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Bruner Chiropractic Health Center, Inc Chiropractor CurrentSince Jul 1, 2005 Accepting new patients

Locations

516 W Crawford Ave
Connellsville, PA 15425
Phone (412) 628-8872

420 W Crawford Ave
Connellsville, PA 15425
Phone (724) 628-6776

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": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411430400000",
    "number": "1063590768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 W CRAWFORD AVE",
            "city": "CONNELLSVILLE",
            "state": "PA",
            "postal_code": "154253031",
            "telephone_number": "724-628-8872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 W CRAWFORD AVE",
            "city": "CONNELLSVILLE",
            "state": "PA",
            "postal_code": "154253031",
            "telephone_number": "724-628-8872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNER",
        "first_name": "MICHAEL",
        "middle_name": "TODD",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2014-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC-006118-L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Connellsville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.