Individual provider Active NPI

Jennifer D Bruce, PT

  • Physical Therapist
  • Huntersville, NC
National Provider Identifier
1689639288
Registry record updated Nov 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
8067 Issued in NC
Practice address
9800 Kincey Ave
Ste 180
Huntersville, NC 28078-8415
Phone
(704) 948-2701
Fax
(704) 948-2859
NPI assigned
Apr 18, 2006
Last updated
Nov 24, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 8067 NC Primary

Addresses

Primary practice location

9800 Kincey Ave
Ste 180
Huntersville, NC 28078-8415

Mailing address

7799 Oak Haven LN
Stanley, NC 28164-7826
Phone (704) 252-0317

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060403000281 NC Practitioner - Physical Therapist in Private Practice 2860400835 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Phoenix Physical Therapy and Sports PerformanceGroup PAC ID 0749209245, 8 clinicians

Practice addresses (Care Compare)

290 N NC 16 Business Hwy
Denver, NC 28037-8011
Phone (704) 483-0777

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8067NCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Phoenix Physical Therapy & Sports Performance Physical Therapist CurrentSince Mar 24, 2016 Accepting new patients
Thomas Hand and Rehabilitation Specialists Limited Partnership Physical Therapist Past Accepting new patients
Thomas Hand and Rehabilitation Specialists Limited Partnership Past Accepting new patients

Locations

290 N NC 16 Business Hwy
Denver, NC 28037
Phone (704) 483-0777

9195 Sherrills Ford Rd
Terrell, NC 28682
Phone 7044830777 ext. 36611

Organizations & group practices 3

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": "1145318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259020800000",
    "number": "1689639288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7799 OAK HAVEN LN",
            "city": "STANLEY",
            "state": "NC",
            "postal_code": "281647826",
            "telephone_number": "704-252-0317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9800 KINCEY AVE",
            "address_2": "STE 180",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280788415",
            "telephone_number": "704-948-2701",
            "fax_number": "704-948-2859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUCE",
        "first_name": "JENNIFER",
        "middle_name": "D",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-18",
        "last_updated": "2009-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "8067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntersville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.