Individual provider Active NPI

Bruce Landon Baridon, DO

  • Internal Medicine Physician
  • Waterloo, IA
National Provider Identifier
1205894581
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2277 Issued in IA
Practice address
1015 S Hackett Rd
Waterloo, IA 50701-3500
Phone
(319) 235-1230
Fax
(319) 235-1229
NPI assigned
May 3, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2277 IA Primary

Addresses

Primary practice location

1015 S Hackett Rd
Waterloo, IA 50701-3500

Mailing address

1015 S Hackett Rd
Waterloo, IA 50701-3500
Phone (319) 235-1230

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121207000500 IA Order and Referring Only - Family PracticePractitioner - General PracticePractitioner - Family Practice 5698927192

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
2277IAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Floyd County Memorial Hospital Commission Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1205894581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 S HACKETT RD",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507013500",
            "telephone_number": "319-235-1230",
            "fax_number": "319-235-1229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 S HACKETT RD",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507013500",
            "telephone_number": "319-235-1230",
            "fax_number": "319-235-1229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARIDON",
        "first_name": "BRUCE",
        "middle_name": "LANDON",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-03",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IA",
            "license": "2277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterloo, IA

Sources for this page

Verify at the official NPI Registry.