Active NPI
David J Brueggemann, AU
- Audiologist
- Anchorage, AK
National Provider Identifier
1679606552
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 22
- Practice address
- 4315 Diplomacy Dr
Attn Sherry Reedy
Anchorage, AK 99508-5926 - Phone
- (907) 729-3971
- Fax
- (907) 729-1542
- NPI assigned
- Mar 13, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Audiologist | 231H00000X | 22 | AK | Primary |
Addresses
Primary practice location
4315 Diplomacy Dr
Attn Sherry Reedy
Anchorage, AK 99508-5926
Mailing address
4315 Diplomacy Dr
Attn Sherry Reedy
Anchorage, AK 99508-5926
Phone (907) 729-3971
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| AU00221 | Medicaid | AK |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22 | AK | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173744000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1376611200000",
"number": "1679606552",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4315 DIPLOMACY DR",
"address_2": "ATTN SHERRY REEDY",
"city": "ANCHORAGE",
"state": "AK",
"postal_code": "995085926",
"telephone_number": "907-729-3971",
"fax_number": "907-729-1542"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4315 DIPLOMACY DR",
"address_2": "ATTN SHERRY REEDY",
"city": "ANCHORAGE",
"state": "AK",
"postal_code": "995085926",
"telephone_number": "907-729-3971",
"fax_number": "907-729-1542"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRUEGGEMANN",
"first_name": "DAVID",
"middle_name": "J",
"credential": "AU",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-13",
"last_updated": "2013-08-16",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "AK",
"license": "22",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "AU00221",
"state": "AK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Anchorage, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.