Organization Active NPI

E Bruns Foot and Ankle SC

  • Foot & Ankle Surgery Podiatrist
  • Kenosha, WI
National Provider Identifier
1487957155
Registry record updated Dec 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
648-025 Issued in WI
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

Updated by the provider on Dec 17, 2010

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)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 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

IdentifierTypeStateIssuer
43215500MedicaidWI

National Provider Directory

National Provider Directory
Tax ID family
E Bruns Foot and Ankle SC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

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.

Verify at the official NPI Registry.