Active NPI
Annclark Bruce, AU.D., CCC-A
- Audiologist
- Tupelo, MS
National Provider Identifier
1467023804
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- A4667
- Practice address
- 618 Pegram Dr
Tupelo, MS 38801-6322 - Phone
- (662) 401-6150
- Fax
- (662) 840-7032
- NPI assigned
- Jul 7, 2021
- 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 |
|---|---|---|---|---|
| Audiologist | 231H00000X | A4667 | MS | Primary |
Addresses
Primary practice location
618 Pegram Dr
Tupelo, MS 38801-6322
Mailing address
618 Pegram Dr
Tupelo, MS 38801-6322
Phone (662) 401-6150
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 82.93 of 100
- Quality
- 74.06
- Promoting interoperability
- 85
- Improvement activities
- 40
- Cost
- 81.53
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A4667 | MS | MD | Audiologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1625616000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1670976000000",
"number": "1467023804",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "618 PEGRAM DR",
"city": "TUPELO",
"state": "MS",
"postal_code": "388016322",
"telephone_number": "662-401-6150"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "618 PEGRAM DR",
"city": "TUPELO",
"state": "MS",
"postal_code": "388016322",
"telephone_number": "662-401-6150",
"fax_number": "662-840-7032"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRUCE",
"first_name": "ANNCLARK",
"name_prefix": "Dr.",
"credential": "AU.D., CCC-A",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-07-07",
"last_updated": "2022-12-14",
"certification_date": "2022-12-14",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "MS",
"license": "A4667",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Tupelo, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.