Chisom O Bruns, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

12738 Issued in MN

Practice address

802 Memorial Dr
Spring Valley, MN 55975-1024

Phone

(507) 288-3443

NPI assigned

Aug 8, 2018

Last updated

Aug 8, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

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.

• Avera Marshall

  dba Avera Marshall Regional Medical Center

  • Critical Access Hospital
  • Marshall, MN
  • NPI 1568401016
  Medicare reassignment NPD
• Avera Marshall

  dba Avera Medical Group Optometry - Marshall

  • Optometrist
  • Marshall, MN
  • NPI 1487422465
  NPD
• Avera Marshall

  dba Avera Medical Group Behavioral Health Services

  • Psychiatry Physician
  • Marshall, MN
  • NPI 1528293172
  NPD

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

{
    "created_epoch": "1533686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533686400000",
    "number": "1073092391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2110 FALCON TER NW",
            "city": "STEWARTVILLE",
            "state": "MN",
            "postal_code": "559761052",
            "telephone_number": "732-439-2948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "802 MEMORIAL DR",
            "city": "SPRING VALLEY",
            "state": "MN",
            "postal_code": "559751024",
            "telephone_number": "507-288-3443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNS",
        "first_name": "CHISOM",
        "middle_name": "O",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-08",
        "last_updated": "2018-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "12738",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Betts, PHARMD
• Cory A Boyce, MD
• Brice Greene D.D.S.
• Keith Casella
• Cindy Powell Therapy & Consulting LLC
• City of Spring Valley (Spring Valley Ambulance Service)
• Community Memorial Hospital & Nursing Home (Spring Valley Home Health)
• Community Memorial Hospital & Nursing Home

• Physician Assistant in Spring Valley, MN
• Providers in Spring Valley, MN by specialty
• Physician Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.