Ellyse Bruursema

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

3806 Issued in MT

Practice address

1234 Whitefish Stage
Kalispell, MT 59901-2753

Phone

(406) 756-7878

Fax

(406) 257-7811

NPI assigned

Jun 13, 2015

Last updated

Jun 13, 2015By 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

Other names 1

• Ellyse Bruursema Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1434153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434153600000",
    "number": "1184005340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1234 WHITEFISH STAGE",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599012753",
            "telephone_number": "406-756-7878",
            "fax_number": "406-257-7811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1234 WHITEFISH STAGE",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599012753",
            "telephone_number": "406-756-7878",
            "fax_number": "406-257-7811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUURSEMA",
        "first_name": "ELLYSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-13",
        "last_updated": "2015-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MT",
            "license": "3806",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELLYSE",
            "last_name": "BRUURSEMA",
            "credential": "DPT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Leslie Anne Brown, LCSW
• Roger G Brown, MD
• Heather Bruner
• Jonathan Brunson, M.D.
• Kaycee D Brustkern, PHARMD
• Buchele Plastic Surgery, P.C.
• Brentley Allen Buchele, M.D.
• Bailey Bucher, APRN
• Natalie J Bucher, RD
• Andrea Buckingham

• Physical Therapist in Kalispell, MT
• Providers in Kalispell, MT by specialty
• Physical Therapist in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 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.