Organization Active NPI

Brugman Behavioral Care, PLLC

  • Clinical Psychologist
  • Gastonia, NC
National Provider Identifier
1275807786
Registry record updated Mar 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
2300 Issued in NC
Legal business name
BRUGMAN BEHAVIORAL CARE, PLLC
Practice address
2907 Rousseau CT
Gastonia, NC 28054-2103
Phone
(704) 869-8878
Fax
(704) 869-8879
NPI assigned
Mar 1, 2012
Last updated
Mar 1, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2012

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

Authorized official

Name
Dr. Joan D Brugman, PSY.D.
Title
Clinical Psychologist/Owner
Phone
(704) 869-8878

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 2300 NC Primary

Addresses

Primary practice location

2907 Rousseau CT
Gastonia, NC 28054-2103

Mailing address

2907 Rousseau CT
Gastonia, NC 28054-2103
Phone (704) 869-8878

Other identifiers 1

IdentifierTypeStateIssuer
6008191MedicaidNC

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1330560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330560000000",
    "number": "1275807786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2907 ROUSSEAU CT",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280542103",
            "telephone_number": "704-869-8878",
            "fax_number": "704-869-8879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2907 ROUSSEAU CT",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280542103",
            "telephone_number": "704-869-8878",
            "fax_number": "704-869-8879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRUGMAN BEHAVIORAL CARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-01",
        "last_updated": "2012-03-01",
        "status": "A",
        "authorized_official_last_name": "BRUGMAN",
        "authorized_official_first_name": "JOAN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST/OWNER",
        "authorized_official_telephone_number": "704-869-8878",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "2300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6008191",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gastonia, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2012; 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.