Individual provider Active NPI

Jamie Lynne Brunet, D.C

  • Sports Physician Chiropractor
  • Tampa, FL
National Provider Identifier
1255691440
Registry record updated Jul 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
License
CH10633 Issued in FL
Practice address
1202 West Carmen Street
Tampa, FL 33606-1303
Phone
(813) 254-3707
Fax
(813) 337-0357
NPI assigned
May 21, 2012
Last updated
Jul 22, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 22, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 10633 FL
Nutrition Chiropractor 111NN1001X CH10633 FL
Sports Physician Chiropractor 111NS0005X CH10633 FL Primary
Rehabilitation Chiropractor 111NR0400X CH10633 FL

Addresses

Primary practice location

1202 West Carmen Street
Tampa, FL 33606-1303

Mailing address

1202 W Carmen St
Tampa, FL 33606-1303
Phone (616) 550-7628

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
10633FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Diesel Health and Recovery, LLC. CurrentSince Aug 1, 2021 Accepting new patients
University Chiropractic Center, Inc. Chiropractor Past Accepting new patients

Locations

1202 W Carmen St
Tampa, FL 33606
Phone (813) 254-3707

Organizations & group practices 3

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": "1337558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626912000000",
    "number": "1255691440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1202 W CARMEN ST",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336061303",
            "telephone_number": "616-550-7628",
            "fax_number": "813-337-0357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1202 WEST CARMEN STREET",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336061303",
            "telephone_number": "813-254-3707",
            "fax_number": "813-337-0357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNET",
        "first_name": "JAMIE",
        "middle_name": "LYNNE",
        "credential": "D.C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-21",
        "last_updated": "2021-07-22",
        "certification_date": "2021-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "10633",
            "primary": false
        },
        {
            "code": "111NN1001X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Nutrition",
            "state": "FL",
            "license": "CH10633",
            "primary": false
        },
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "FL",
            "license": "CH10633",
            "primary": true
        },
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "FL",
            "license": "CH10633",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2021; 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.