Individual provider Active NPI

Virginia Bertha-Anne Brugger, CNP

  • Family Nurse Practitioner
  • Lorain, OH
National Provider Identifier
1457671091
Registry record updated Aug 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11454-NP Issued in OH
Practice address
3745 Grove Ave.
Lorain County Health & Dentistry
Lorain, OH 44055
Phone
(440) 240-1655
Fax
(440) 233-0194
NPI assigned
Jun 6, 2010
Last updated
Aug 23, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11454-NP OH Primary

Addresses

Primary practice location

3745 Grove Ave.
Lorain County Health & Dentistry
Lorain, OH 44055

Mailing address

1205 Broadway
Lorain County Health & Dentistry
Lorain, OH 44052-3409
Phone (440) 240-1655

Other identifiers 1

IdentifierTypeStateIssuer
3072008MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20100622000473 OH Practitioner - Nurse Practitioner 9931230802 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cleveland ClinicGroup PAC ID 1850203555, 6,954 clinicians

Practice addresses (Care Compare)

5700 Cooper Foster Park Rd W
Lorain, OH 44053-4152
Phone (440) 204-7400

8950 Euclid Ave
Cleveland, OH 44195-0001
Phone (216) 444-8950

9500 Euclid Ave
Cleveland, OH 44195-0001

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11454-NPOHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lorain County Health & Dentistry CurrentSince Oct 29, 2012 Accepting new patients
Lorain County Health & Dentistry Current Accepting new patients
The Cleveland Clinic Foundation CurrentSince Feb 3, 2016 Accepting new patients
Lorain County Health & Dentistry CurrentSince Oct 29, 2012 Accepting new patients

Locations

9500 Euclid Ave
Cleveland, OH 44195
Phone (216) 442-1270

1205 Broadway
Lorain, OH 44052

3745 Grove Ave
Lorain, OH 44055
Phone (440) 240-1901

Organizations & group practices 4

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1275782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377216000000",
    "number": "1457671091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1205 BROADWAY",
            "address_2": "LORAIN COUNTY HEALTH & DENTISTRY",
            "city": "LORAIN",
            "state": "OH",
            "postal_code": "440523409",
            "telephone_number": "440-240-1655",
            "fax_number": "440-233-0194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3745 GROVE AVE.",
            "address_2": "LORAIN COUNTY HEALTH & DENTISTRY",
            "city": "LORAIN",
            "state": "OH",
            "postal_code": "44055",
            "telephone_number": "440-240-1655",
            "fax_number": "440-233-0194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUGGER",
        "first_name": "VIRGINIA",
        "middle_name": "BERTHA-ANNE",
        "name_prefix": "Ms.",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-06",
        "last_updated": "2013-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "11454-NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3072008",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lorain, OH

Sources for this page

Verify at the official NPI Registry.