Active NPI
Robert Jordan Bruyn Jr., D.C.
- Chiropractor
- Madison, TN
National Provider Identifier
1063686400
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 2060
- Practice address
- 2021 Gallatin Pike N Ste 112
Madison, TN 37115-2015 - Phone
- (615) 859-7003
- NPI assigned
- Apr 16, 2008
- Last updated
- Apr 16, 2008
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 2060 | TN | Primary |
Addresses
Primary practice location
2021 Gallatin Pike N Ste 112
Madison, TN 37115-2015
Mailing address
2021 Gallatin Pike N Ste 112
Madison, TN 37115-2015
Phone (615) 859-7003
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 |
|---|---|---|---|
| 2060 | TN | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1208304000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1208304000000",
"number": "1063686400",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2021 GALLATIN PIKE N STE 112",
"city": "MADISON",
"state": "TN",
"postal_code": "371152015",
"telephone_number": "615-859-7003"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2021 GALLATIN PIKE N STE 112",
"city": "MADISON",
"state": "TN",
"postal_code": "371152015",
"telephone_number": "615-859-7003"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRUYN",
"first_name": "ROBERT",
"middle_name": "JORDAN",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-04-16",
"last_updated": "2008-04-16",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "TN",
"license": "2060",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Madison, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 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.