Individual provider Active NPI

Robert Ernest Bruce Jr., LSW

  • Social Worker
  • Xenia, OH
National Provider Identifier
1588135040
Registry record updated Dec 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
S.1101315 Issued in OH
Practice address
2081 Drummond Dr
Xenia, OH 45385-4023
Phone
(937) 264-0084
Fax
(937) 264-0095
NPI assigned
Dec 10, 2018
Last updated
Dec 10, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 10, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X S.1101315 OH Primary

Addresses

Primary practice location

2081 Drummond Dr
Xenia, OH 45385-4023

Mailing address

1785 Big Hill Rd
Dayton, OH 45439-2219
Phone (937) 264-0084

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

State licenses

LicenseStateTypeSpecialty
S.1101315OHMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Children Have Options in Caring Environments Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/choicesohio/r4/

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1544400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544400000000",
    "number": "1588135040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1785 BIG HILL RD",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454392219",
            "telephone_number": "937-264-0084",
            "fax_number": "937-264-0095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2081 DRUMMOND DR",
            "city": "XENIA",
            "state": "OH",
            "postal_code": "453854023",
            "telephone_number": "937-264-0084",
            "fax_number": "937-264-0095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUCE",
        "first_name": "ROBERT",
        "middle_name": "ERNEST",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "LSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-12-10",
        "last_updated": "2018-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S.1101315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Xenia, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2018; 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.