Scott Louis Bruce, EDD, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

RT000201A Issued in PA

Practice address

104 N. Caraway Rd
Smith 301
Jonesboro, AR 72401

Phone

(870) 972-3822

NPI assigned

Feb 17, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1140134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666224000000",
    "number": "1619942364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 NEW POND HILL DR",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724058026",
            "telephone_number": "423-240-7180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 N. CARAWAY RD",
            "address_2": "SMITH 301",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "72401",
            "telephone_number": "870-972-3822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUCE",
        "first_name": "SCOTT",
        "middle_name": "LOUIS",
        "name_prefix": "Dr.",
        "credential": "EDD, ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-17",
        "last_updated": "2022-10-20",
        "certification_date": "2022-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "PA",
            "license": "RT000201A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Martin Ruben Broyles, P.T.
• Bruce W. Taylor, D.D.S.
• Arthur Paul Bruce
• Kaylynn Bruce
• Kristen Nicole Bruce, LPC
• Darren Brucksieker, CRNA
• Demetri Antoni Bruner, MCD, CCC-SLP
• Pamela Brunkhorst, LPN
• Sarah L Brunner, QBHP
• Bryan Darling, DDS, MD, PA

• Athletic Trainer in Jonesboro, AR
• Providers in Jonesboro, AR by specialty
• Athletic Trainer in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2022; 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.