George S Bruins, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

4301057804 Issued in MI

Practice address

4600 Breton Rd SE
Ste 102
Kentwood, MI 49508-5220

Phone

(616) 391-9700

Fax

(616) 391-9707

NPI assigned

Jun 10, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Baxter Community Center

  • Public Health or Welfare Agency
  • Grand Rapids, MI
  • NPI 1164625109
  Medicare reassignment NPD

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

{
    "created_epoch": "1118361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300233600000",
    "number": "1265436836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4600 BRETON RD SE",
            "address_2": "STE 102",
            "city": "KENTWOOD",
            "state": "MI",
            "postal_code": "495085220",
            "telephone_number": "616-391-9700",
            "fax_number": "616-391-9707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 BRETON RD SE",
            "address_2": "STE 102",
            "city": "KENTWOOD",
            "state": "MI",
            "postal_code": "495085220",
            "telephone_number": "616-391-9700",
            "fax_number": "616-391-9707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUINS",
        "first_name": "GEORGE",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-10",
        "last_updated": "2011-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301057804",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3149083",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Thomas Wesley Brink, MD
• Angela Brinks
• Julie Elizabeth Brown
• Latoya Sherese Brown
• Laurie Kay Brown, COTA
• Amanda Lenore Bryant, PHARMD
• Erica L Buchholz, RBT
• Margaret Elaine Bultman, BEHAVIOR TECHNICIAN
• Marissa Bultsma
• Sydney Katherine Bunch

• Family Medicine Physician in Kentwood, MI
• Providers in Kentwood, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.