Individual provider Active NPI

Bruce K Felder, D.D.S

  • Endodontics
  • Pensacola, FL
National Provider Identifier
1376553495
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
8414 Issued in FL
Practice address
3000 Langley Ave
Suite 100
Pensacola, FL 32504-4700
Phone
(850) 477-2323
NPI assigned
Aug 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 8414 FL Primary

Addresses

Primary practice location

3000 Langley Ave
Suite 100
Pensacola, FL 32504-4700

Mailing address

3000 Langley Ave
Suite 100
Pensacola, FL 32504-4700
Phone (850) 477-2323

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Feb 9, 2016 through Feb 9, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
8414FLMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376553495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 LANGLEY AVE",
            "address_2": "SUITE 100",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325044700",
            "telephone_number": "850-477-2323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 LANGLEY AVE",
            "address_2": "SUITE 100",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325044700",
            "telephone_number": "850-477-2323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FELDER",
        "first_name": "BRUCE",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "FL",
            "license": "8414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

Verify at the official NPI Registry.