Active NPI
E Bruns Foot and Ankle SC
- Foot & Ankle Surgery Podiatrist
- Kenosha, WI
National Provider Identifier
1487957155
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Foot & Ankle Surgery Podiatrist
- License
- 648-025
- Legal business name
- E BRUNS FOOT AND ANKLE SC
- Practice address
- 9916 75TH St
Suite 201
Kenosha, WI 53142-7583 - Phone
- (262) 248-9565
- Fax
- (262) 248-0065
- NPI assigned
- Dec 17, 2010
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Eric Carl Bruns, DPM
- Title
- Solo Pratitioner
- Phone
- (262) 248-9565
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Foot & Ankle Surgery Podiatrist | 213ES0103X | 648-025 | WI | Primary |
Addresses
Primary practice location
9916 75TH St
Suite 201
Kenosha, WI 53142-7583
Mailing address
160 E Geneva SQ
Lake Geneva, WI 53147-9694
Phone (262) 248-9565
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 43215500 | Medicaid | WI |
National Provider Directory
National Provider Directory- Tax ID family
- E Bruns Foot and Ankle SC
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Foot & Ankle Surgery Podiatrist
- Lake Geneva, WI
- NPI 1548564016
-
- Foot & Ankle Surgery Podiatrist
- Racine, WI
- NPI 1649574054
Locations
160 E Geneva Sq
Lake Geneva, WI 53147
Phone (262) 248-9565
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1292544000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1292544000000",
"number": "1487957155",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "160 E GENEVA SQ",
"city": "LAKE GENEVA",
"state": "WI",
"postal_code": "531479694",
"telephone_number": "262-248-9565",
"fax_number": "262-248-0065"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9916 75TH ST",
"address_2": "SUITE 201",
"city": "KENOSHA",
"state": "WI",
"postal_code": "531427583",
"telephone_number": "262-248-9565",
"fax_number": "262-248-0065"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "E BRUNS FOOT AND ANKLE SC",
"organizational_subpart": "NO",
"enumeration_date": "2010-12-17",
"last_updated": "2010-12-17",
"status": "A",
"authorized_official_last_name": "BRUNS",
"authorized_official_first_name": "ERIC",
"authorized_official_middle_name": "CARL",
"authorized_official_title_or_position": "SOLO PRATITIONER",
"authorized_official_telephone_number": "262-248-9565",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "DPM"
},
"taxonomies": [
{
"code": "213ES0103X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Podiatrist, Foot & Ankle Surgery",
"state": "WI",
"license": "648-025",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "43215500",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Kenosha, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.