Individual provider Active NPI

Ijzan Bruns, CNP

  • Family Nurse Practitioner
  • Piqua, OH
National Provider Identifier
1487217428
Registry record updated May 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.024490 Issued in OH
Practice address
1510 Covington Ave
Piqua, OH 45356-2801
Phone
(937) 381-8244
NPI assigned
Apr 16, 2019
Last updated
May 21, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN.CNP.024490 OH Primary
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

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
I20190814002850 OH Practitioner - Nurse Practitioner 1456688373 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Ohio State University College of Medicine, 2018
Medicare assignment
May accept Medicare assignment
Group practices
Vitas Solutions IncGroup PAC ID 7012087166, 55 clinicians

Practice addresses (Care Compare)

3055 Kettering Blvd
Suite 320
Moraine, OH 45439-1981
Phone (937) 299-5379

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN.CNP.024490OHMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hospitalist Medicine Physicians of Ohio, Professional Corporation Nurse Practitioner CurrentSince Aug 1, 2019 Accepting new patients
Vitas Solutions Inc Nurse Practitioner CurrentSince Oct 26, 2021 Accepting new patients
The Little Clinic of Ohio LLC Family CurrentSince May 19, 2020 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

181 Taylor Ave
Ste N114
Columbus, OH 43203

199 Graceland Blvd
Columbus, OH 43214
Phone (614) 410-2814

3055 Kettering Blvd
Ste 320
Moraine, OH 45439
Phone (937) 299-5379

1510 Covington Ave
Piqua, OH 45356
Phone (937) 381-8244

Organizations & group practices 3

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 1

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": "1555372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590019200000",
    "number": "1487217428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2620 ELM HILL PIKE",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372143108",
            "telephone_number": "615-425-4200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1510 COVINGTON AVE",
            "city": "PIQUA",
            "state": "OH",
            "postal_code": "453562801",
            "telephone_number": "937-381-8244"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "181 Taylor Ave",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432031779",
            "country_code": "US",
            "telephone_number": "614-257-2203",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRUNS",
        "first_name": "IJZAN",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-16",
        "last_updated": "2020-05-21",
        "certification_date": "2020-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.024490",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "APRN.CNP.024490",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Piqua, OH

Sources for this page

Verify at the official NPI Registry.