Individual provider Active NPI

Susan KS Bruner, ARNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Spokane, WA
National Provider Identifier
1376849737
Registry record updated Jul 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP60211296 Issued in WA
Practice address
1817 E Springfield Ave
Suite E
Spokane, WA 99202-2913
Phone
(509) 262-6406
NPI assigned
Feb 2, 2011
Last updated
Jul 15, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2011

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP60211296 WA Primary
Psychiatric/Mental Health Registered Nurse 163WP0808X RN00151042 WA
Adult Psychiatric/Mental Health Registered Nurse 163WP0809X RN00151042 WA

Addresses

Primary practice location

1817 E Springfield Ave
Suite E
Spokane, WA 99202-2913

Mailing address

1817 E Springfield Ave
Suite E
Spokane, WA 99202-2913
Phone (509) 262-6406

Other identifiers 1

IdentifierTypeStateIssuer
G8900962OtherWAMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110623000485 WA Practitioner - Nurse Practitioner 7719165604 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1403 S Grand Blvd
101S
Spokane, WA 99203-2272
Phone (509) 389-1494

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN00151042WAMDPsychiatric/Mental Health Registered Nurse
AP60211296WAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Spokane Resource Group, PLLC Psychiatric/Mental Health CurrentSince Nov 12, 2011 Accepting new patients
Palouse River Counseling Center CurrentSince May 1, 2011 Accepting new patients

Locations

340 NE Maple St
Pullman, WA 99163
Phone (509) 334-1133

1403 S Grand Blvd
Ste 101S
Spokane, WA 99203
Phone (509) 389-1494

1817 E Springfield Ave
Ste E
Spokane, WA 99202
Phone (509) 262-6406

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1296604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310688000000",
    "number": "1376849737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1817 E SPRINGFIELD AVE",
            "address_2": "SUITE E",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992022913",
            "telephone_number": "509-262-6406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1817 E SPRINGFIELD AVE",
            "address_2": "SUITE E",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992022913",
            "telephone_number": "509-262-6406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNER",
        "first_name": "SUSAN",
        "middle_name": "KS",
        "name_prefix": "Ms.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-02-02",
        "last_updated": "2011-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP60211296",
            "primary": true
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "WA",
            "license": "RN00151042",
            "primary": false
        },
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "WA",
            "license": "RN00151042",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "G8900962",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.