Ijzan Bruns, CNP
Individual provider Active NPI Family Nurse Practitioner · Piqua, OH
NPI 1487217428 · NPPES record last updated May 21, 2020
Key facts
- NPI
- 1487217428
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- APRN.CNP.024490 (OH)
- Practice address
- 1510 Covington Ave
Piqua, OH 45356-2801 - Phone
- (937) 381-8244
- NPI assigned
- Apr 16, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Ohio State University College of Medicine, 2018
- Medicare assignment
- May accept Medicare assignment
- Group practices
- Vitas Solutions Inc
Practice addresses (Care Compare)
3055 Kettering Blvd
Suite 320
Moraine, OH 45439-1981
Phone (937) 299-5379
Hospital & facility affiliations
- Kettering Health Dayton
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190814002850 | OH | Practitioner - Nurse Practitioner | 1456688373 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Nurse Practitioner, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APRN.CNP.024490 | OH | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hospitalist Medicine Physicians of Ohio, Professional Corporation | Nurse Practitioner | Current |
Accepting new patients |
| Vitas Solutions Inc | Nurse Practitioner | Current |
Accepting new patients |
| The Little Clinic of Ohio LLC | Family | Current |
Accepting new patients |
Locations
2420 Lake Ave
Ashtabula, OH 44004
Phone (216) 986-2919
255 E 5th St
Ste 1050
Cincinnati, OH 45202
181 Taylor Ave
Columbus, OH 43203
Phone (614) 257-2358
199 Graceland Blvd
Columbus, OH 43214
Phone (614) 410-2814
181 Taylor Ave
Ste N114
Columbus, OH 43203
3055 Kettering Blvd
Ste 320
Moraine, OH 45439
Phone (937) 299-5379
1510 Covington Ave
Piqua, OH 45356
Phone (937) 381-8244
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | APRN.CNP.024490 | OH | Yes |
| Nurse Practitioner | 363L00000X | APRN.CNP.024490 | OH |
Addresses
Primary practice location
1510 Covington Ave
Piqua, OH 45356-2801
Mailing address
2620 Elm Hill Pike
Nashville, TN 37214-3108
Phone (615) 425-4200
Other practice location 1
181 Taylor Ave
Columbus, OH 43203-1779
Phone (614) 257-2203
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| APRN.CNP.024490 | Other | OH | CERTIFIED NURSE PRACTITIONER LICENSE |
Other providers in Piqua, OH
- Janice F Brittingham
- Brookdale Senior Living Communities Inc
- Elaine Brown
- Kaitlin Brown
- Leanna Marie Brown
- Buckeye Forest at Piqua LLC
- Glenn A Buller
- Stephanie Ann Burdette
- Lauren Faith Burger
- James Burkhardt
All providers in Piqua, OH · Family Nurse Practitioner in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 21, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.