Bruce Ronald Hyde, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

4301073551 Issued in MI

Practice address

658 E Main St
Centreville, MI 49032

Phone

(269) 467-3228

Fax

(269) 467-3500

NPI assigned

Aug 15, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1218758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485993600000",
    "number": "1669628160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "658 E MAIN ST",
            "city": "CENTREVILLE",
            "state": "MI",
            "postal_code": "49032",
            "telephone_number": "269-467-3228",
            "fax_number": "269-467-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "658 E MAIN ST",
            "city": "CENTREVILLE",
            "state": "MI",
            "postal_code": "49032",
            "telephone_number": "269-467-3228",
            "fax_number": "269-467-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HYDE",
        "first_name": "BRUCE",
        "middle_name": "RONALD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-15",
        "last_updated": "2017-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "G69423",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301073551",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "4301073551",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "G69423",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Genesis Herbert, BS
• Sharon A Hertlein, RN
• Sarah Howk
• Crystal Hughes
• Lauri Hummel, LMSW
• Elizabeth Jansen, LLMSW
• Amanda Lynn Johnson, LMSW - CLINICAL
• Angela Nichoele Johnson, LLPC, LBSW
• Erin Johnson
• Karah Dennell Johnson, LLMSW

• Family Medicine Physician in Centreville, MI
• Providers in Centreville, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 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.

Verify at the official NPI Registry.