Active NPI
Michele Marie Brunsman, MS, RD
- Registered Dietitian
- Tulsa, OK
National Provider Identifier
1578086138
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 1818
- Practice address
- 1120 S Utica Ave
Tulsa, OK 74104-4012 - Phone
- (918) 579-8266
- NPI assigned
- Jul 25, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 1818 | OK | Primary |
Addresses
Primary practice location
1120 S Utica Ave
Tulsa, OK 74104-4012
Mailing address
6746 E 125TH St S
Bixby, OK 74008-2944
Phone (402) 366-5674
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1818 | Other | OK | STATE LISCENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1500940800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1500940800000",
"number": "1578086138",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6746 E 125TH ST S",
"city": "BIXBY",
"state": "OK",
"postal_code": "740082944",
"telephone_number": "402-366-5674"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1120 S UTICA AVE",
"city": "TULSA",
"state": "OK",
"postal_code": "741044012",
"telephone_number": "918-579-8266"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRUNSMAN",
"first_name": "MICHELE",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"credential": "MS, RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-07-25",
"last_updated": "2017-07-25",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "OK",
"license": "1818",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LISCENSE",
"identifier": "1818",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tulsa, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.