Active NPI
Bruce Lemon
- Contractor
- Detroit Lakes, MN
National Provider Identifier
1295059160
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Contractor
- Practice address
- 30195 County Highway 54
Detroit Lakes, MN 56501-7414 - Phone
- (218) 847-0055
- NPI assigned
- Mar 22, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | Primary |
Addresses
Primary practice location
30195 County Highway 54
Detroit Lakes, MN 56501-7414
Mailing address
30195 County Highway 54
Detroit Lakes, MN 56501-7414
Phone (218) 847-0055
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)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1269216000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1269216000000",
"number": "1295059160",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30195 COUNTY HIGHWAY 54",
"city": "DETROIT LAKES",
"state": "MN",
"postal_code": "565017414",
"telephone_number": "218-847-0055"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30195 COUNTY HIGHWAY 54",
"city": "DETROIT LAKES",
"state": "MN",
"postal_code": "565017414",
"telephone_number": "218-847-0055"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEMON",
"first_name": "BRUCE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-03-22",
"last_updated": "2010-03-22",
"status": "A"
},
"taxonomies": [
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Detroit Lakes, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.