Active NPI
Johanna Shalom Bruning, ARNP
- Family Nurse Practitioner
- Spokane Valley, WA
National Provider Identifier
1407820632
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- AP30007072
- Practice address
- 12410 E Sinto Ave
Suite 101
Spokane Valley, WA 99216-2199 - Phone
- (509) 838-2531
- NPI assigned
- Feb 14, 2006
- Last updated
- Dec 12, 2008
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | AP30007072 | WA | Primary |
Addresses
Primary practice location
12410 E Sinto Ave
Suite 101
Spokane Valley, WA 99216-2199
Mailing address
PO Box 3649
Spokane, WA 99220-3649
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0221856 | Other | WA | L&I |
| 9646514 | Medicaid | WA |
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)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AP30007072 | WA | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139875200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1229040000000",
"number": "1407820632",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3649",
"city": "SPOKANE",
"state": "WA",
"postal_code": "992203649"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12410 E SINTO AVE",
"address_2": "SUITE 101",
"city": "SPOKANE VALLEY",
"state": "WA",
"postal_code": "992162199",
"telephone_number": "509-838-2531"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRUNING",
"first_name": "JOHANNA",
"middle_name": "SHALOM",
"credential": "ARNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-02-14",
"last_updated": "2008-12-12",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "WA",
"license": "AP30007072",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "L&I",
"identifier": "0221856",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9646514",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Spokane Valley, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.