Individual provider Active NPI

Kristi Bruno-Wittingham

  • Family Nurse Practitioner
  • Pembroke Pines, FL
National Provider Identifier
1164804365
Registry record updated Jun 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
9168980 Issued in FL
Practice address
1140 NW 185TH Ter
Pembroke Pines, FL 33029-3653
Phone
(954) 232-2753
NPI assigned
Jun 24, 2015
Last updated
Jun 24, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 9168980 FL Primary

Addresses

Primary practice location

1140 NW 185TH Ter
Pembroke Pines, FL 33029-3653

Mailing address

1140 NW 185TH Ter
Pembroke Pines, FL 33029-3653

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

LicenseStateTypeSpecialty
9168980FLMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1435104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435104000000",
    "number": "1164804365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1140 NW 185TH TER",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330293653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 NW 185TH TER",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330293653",
            "telephone_number": "954-232-2753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNO-WITTINGHAM",
        "first_name": "KRISTI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-24",
        "last_updated": "2015-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "9168980",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2015; 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.