Active NPI
Julia Bruder, CNIM
- Electroneurodiagnostic Specialist/Technologist
- Boulder, CO
National Provider Identifier
1609904200
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Electroneurodiagnostic Specialist/Technologist
- License
- 882
- Practice address
- 1155 Alpine Ave
Suite 320
Boulder, CO 80304-3495 - Phone
- (303) 531-7080
- Fax
- (303) 998-0007
- NPI assigned
- Mar 2, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Electroneurodiagnostic Specialist/Technologist | 246ZE0600X | 882 | IL | Primary |
Addresses
Primary practice location
1155 Alpine Ave
Suite 320
Boulder, CO 80304-3495
Mailing address
1155 Alpine Ave
Suite 320
Boulder, CO 80304-3495
Phone (303) 531-7080
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
| License | State | Type | Specialty |
|---|---|---|---|
| 882 | IL | MD | Electroneurodiagnostic Specialist/Technologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172793600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1609904200",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1155 ALPINE AVE",
"address_2": "SUITE 320",
"city": "BOULDER",
"state": "CO",
"postal_code": "803043495",
"telephone_number": "303-531-7080",
"fax_number": "303-998-0007"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1155 ALPINE AVE",
"address_2": "SUITE 320",
"city": "BOULDER",
"state": "CO",
"postal_code": "803043495",
"telephone_number": "303-531-7080",
"fax_number": "303-998-0007"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRUDER",
"first_name": "JULIA",
"credential": "CNIM",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "246ZE0600X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other, Electroneurodiagnostic",
"state": "IL",
"license": "882",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boulder, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.