Bruce Pearson PA

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

003660 Issued in MN

Legal business name

BRUCE PEARSON PA

Practice address

12805 Highway 55 Ste 310
Plymouth, MN 55441-3826

Phone

(763) 476-4770

NPI assigned

May 1, 2008

Organization subpart

No

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

Authorized official

Name

Bruce Pearson, DCNPI 1598802035

Title

Doctor/Owner

Phone

(763) 476-4770

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Natural Chiropractic Center Doing business as

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Bruce Eugene Pearson, D.C.

  • Chiropractor
  • Plymouth, MN
  • NPI 1598802035
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1209600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730332800000",
    "number": "1508032376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12805 HIGHWAY 55 STE 310",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554413826",
            "telephone_number": "763-476-4770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12805 HIGHWAY 55 STE 310",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554413826",
            "telephone_number": "763-476-4770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRUCE PEARSON PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-01",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-31",
        "status": "A",
        "authorized_official_last_name": "PEARSON",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_title_or_position": "DOCTOR/OWNER",
        "authorized_official_telephone_number": "763-476-4770",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "003660",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "40B51PE",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Natural Chiropractic Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Alissya Brown
• Brandy Tessa Brown, MA, LAMFT
• Faith Ellen Brown
• Jennifer Rafferty Brown, OTR
• Patrick Ray Brown, CRNA, DNAP
• Andrea Bryan, PA-C
• Ondrea Lee Bryans, MS LMFT
• Philip Oppong Buabeng
• Kimberley Anne Bugajski, O.D.
• Kristen Alexa Burnett, PSY.D., LP

• All providers in Plymouth, MN
• Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.