Individual provider Active NPI

Mitchell James Bruning, PT

  • Physical Therapist
  • Phoenix, AZ
National Provider Identifier
1508917683
Registry record updated Jan 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
3369 Issued in AZ
Practice address
4141 E Thomas Rd
Phoenix, AZ 85018-7515
Phone
(602) 954-7742
Fax
(602) 955-2229
NPI assigned
Jan 15, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physical Therapist 2251S0007X 3369 AZ
Physical Therapist 225100000X 3369 AZ Primary

Addresses

Primary practice location

4141 E Thomas Rd
Phoenix, AZ 85018-7515

Mailing address

PO Box 15858
Phoenix, AZ 85060-5858
Phone (602) 954-7742

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200224000669 AZ Practitioner - Physical Therapist in Private Practice 8123454071 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pritchette Physical TherapyGroup PAC ID 5193882124, 5 clinicians

Practice addresses (Care Compare)

1331 E Chandler Blvd
Suite 102/ 103
Phoenix, AZ 85048-6274
Phone (480) 371-1555

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3369AZMDSports Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
BHSM Rehabilitation, LLC Current Accepting new patients
BHSM Rehabilitation, LLC CurrentSince Sep 24, 2021 Accepting new patients
BHSM Rehabilitation, LLC CurrentSince Sep 24, 2021 Accepting new patients
Pritchette Physical Therapy CurrentSince Feb 7, 2024 Accepting new patients
Rehab Plus Sports Conditioning, LLC Orthopedic Past Accepting new patients

Locations

1301 W University Ave
Flagstaff, AZ 86001
Phone (928) 556-8607

3507 S Mercy Rd
Ste A
Gilbert, AZ 85297
Phone (480) 926-0404

2120 Airway Ave
Kingman, AZ 86409
Phone (928) 757-1211

2225 W Southern Ave
Bldg 1300
Mesa, AZ 85202
Phone (480) 330-0456

4730 E Warner Rd
Ste 5
Phoenix, AZ 85044
Phone (480) 785-5415

1331 E Chandler Blvd
Ste 102
Phoenix, AZ 85048
Phone (480) 371-1555

4141 E Thomas Rd
Phoenix, AZ 85018
Phone (602) 954-7742

4232 E Chandler Blvd
Ste 24
Phoenix, AZ 85048
Phone (602) 362-3701

4200 E Camelback Rd
Ste 103
Phoenix, AZ 85018
Phone (602) 858-3307

1661 E Camelback Rd
Ste 152
Phoenix, AZ 85016
Phone (602) 955-8885

2830 N 42nd St
Phoenix, AZ 85008
Phone (602) 954-7742

9377 E Bell Rd
Ste 349
Scottsdale, AZ 85260
Phone (602) 313-1549

6380 E Grant Rd
Ste 100
Tucson, AZ 85715
Phone (520) 420-1150

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1168819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610928000000",
    "number": "1508917683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15858",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850605858",
            "telephone_number": "602-954-7742",
            "fax_number": "602-955-2229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4141 E THOMAS RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850187515",
            "telephone_number": "602-954-7742",
            "fax_number": "602-955-2229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNING",
        "first_name": "MITCHELL",
        "middle_name": "JAMES",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-15",
        "last_updated": "2021-01-18",
        "certification_date": "2021-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": "AZ",
            "license": "3369",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "3369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.