Bradley Gene Gruver, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

0301979 Issued in WA

Practice address

124 E Rowan Ave
Suite 101
Spokane, WA 99207-1214

Phone

(509) 487-5456

Fax

(509) 484-0082

NPI assigned

Oct 24, 2006

Last updated

Oct 11, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Bradley G Gruver & Kenneth L Koch PTRS

  • Optometrist
  • Spokane, WA
  • NPI 1356412605
  NPD (past)

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192060800000",
    "number": "1396828950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 E ROWAN AVE",
            "address_2": "SUITE 101",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992071214",
            "telephone_number": "509-487-5456",
            "fax_number": "509-484-0082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 E ROWAN AVE",
            "address_2": "SUITE 101",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992071214",
            "telephone_number": "509-487-5456",
            "fax_number": "509-484-0082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUVER",
        "first_name": "BRADLEY",
        "middle_name": "GENE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-24",
        "last_updated": "2007-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "0301979",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2021509",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erica Ruth Gruen, LMHC
• Gabriella Evangeline Gruen, MSW, LSWAIC
• Duane C Grummons, D.D.S., M.S.D.
• Jenny Leigh Grummons, BA
• Jennifer Grushon
• Lindsay Gruwell
• Jolanta Grzybowski, SLP
• Ashlee Guckel, LMHC
• Lupe Guel
• Doris Renae Guelich, L.M.P.

• Optometrist in Spokane, WA
• Providers in Spokane, WA by specialty
• Optometrist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2007; 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.