NPIMap

Organization Active NPI

Audrey Bruell, M.D. P.C.

  • Dermatology Physician
  • Livonia, MI
National Provider Identifier
1306965983
Registry record updated Apr 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
4301062941 Issued in MI
Legal business name
AUDREY BRUELL, M.D. P.C.
Practice address
37605 Pembroke Ave
James James Towne
Livonia, MI 48152-1050
Phone
(734) 591-7931
Fax
(734) 464-0335
NPI assigned
Mar 28, 2007
Last updated
Apr 9, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2010

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

Authorized official

Name
Kathy Mayer, CPC
Title
Billing Supervisor
Phone
(989) 666-4775

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 4301062941 MI Primary

Addresses

Primary practice location

37605 Pembroke Ave
James James Towne
Livonia, MI 48152-1050

Mailing address

37605 Pembroke
James James Towne
Livonia, MI 48152-1050
Phone (734) 591-7931

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 57

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 57

NPI Registry JSON

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1270771200000",
    "number": "1306965983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37605 PEMBROKE",
            "address_2": "JAMES JAMES TOWNE",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481521050",
            "telephone_number": "734-591-7931",
            "fax_number": "734-464-0335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37605 PEMBROKE AVE",
            "address_2": "JAMES JAMES TOWNE",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481521050",
            "telephone_number": "734-591-7931",
            "fax_number": "734-464-0335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUDREY BRUELL, M.D. P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-28",
        "last_updated": "2010-04-09",
        "status": "A",
        "authorized_official_last_name": "MAYER",
        "authorized_official_first_name": "KATHY",
        "authorized_official_title_or_position": "BILLING SUPERVISOR",
        "authorized_official_telephone_number": "989-666-4775",
        "authorized_official_credential": "CPC"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MI",
            "license": "4301062941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Livonia, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 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.

Verify at the official NPI Registry.