Individual provider Active NPI

Linda S Bruinsma, DC

  • Chiropractor
  • Wyoming, MI
National Provider Identifier
1508957150
Registry record updated Mar 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301004232 Issued in MI
Practice address
3555 Byron Center Ave
Wyoming, MI 49519
Phone
(616) 531-3566
Fax
(616) 531-2715
NPI assigned
Sep 27, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 26, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2301004232 MI Primary

Addresses

Primary practice location

3555 Byron Center Ave
Wyoming, MI 49519

Mailing address

3555 Byron Center Ave
Wyoming, MI 49519
Phone (616) 531-3566

Other identifiers 2

IdentifierTypeStateIssuer
P52096OtherBLUE CORE NETWORK
950D150990OtherMIBCBS OF MICHIGAN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120430000153 MI Practitioner - Chiropractic 2860460961 Practice locations: Wyoming, MI

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2301004232MIMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269561600000",
    "number": "1508957150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3555 BYRON CENTER AVE",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "49519",
            "telephone_number": "616-531-3566",
            "fax_number": "616-531-2715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3555 BYRON CENTER AVE",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "49519",
            "telephone_number": "616-531-3566",
            "fax_number": "616-531-2715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUINSMA",
        "first_name": "LINDA",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-27",
        "last_updated": "2010-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301004232",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CORE NETWORK",
            "identifier": "P52096",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MICHIGAN",
            "identifier": "950D150990",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyoming, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2010; 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.