Individual provider Active NPI

Bradley David Kusler, M.D.

  • Military Health Care Provider
  • Offutt AFB, NE
National Provider Identifier
1104988385
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Military Health Care ProviderTaxonomy code 171000000X
License
29399 Issued in IA
Practice address
105 Grant Cir Ste 133
55TH Amds-SGPS
Offutt a F B, NE 68113-4041
Phone
(402) 294-7346
Fax
(402) 294-9138
NPI assigned
Dec 14, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Military Health Care Provider 171000000X 29399 IA Primary

Addresses

Primary practice location

105 Grant Cir Ste 133
55TH Amds-SGPS
Offutt a F B, NE 68113-4041

Mailing address

408 Fawn Park Cir
Council Bluffs, IA 51503-5294
Phone (402) 321-4297

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
29399IAMDMilitary Health Care Provider

NPI Registry JSON

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104988385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 FAWN PARK CIR",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515035294",
            "telephone_number": "402-321-4297",
            "fax_number": "712-328-8295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 GRANT CIR STE 133",
            "address_2": "55TH AMDS-SGPS",
            "city": "OFFUTT A F B",
            "state": "NE",
            "postal_code": "681134041",
            "telephone_number": "402-294-7346",
            "fax_number": "402-294-9138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUSLER",
        "first_name": "BRADLEY",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171000000X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider",
            "state": "IA",
            "license": "29399",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Offutt AFB, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.