Individual provider Active NPI

Brian Bruns

  • Pharmacist
  • Belvidere, IL
National Provider Identifier
1821378373
Registry record updated Aug 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
051.288974 Issued in IL
Practice address
230 W Chrysler Dr
Belvidere, IL 61008-6304
Phone
(815) 544-4790
Fax
(815) 547-4827
NPI assigned
Aug 27, 2011
Last updated
Aug 27, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 051.288974 IL Primary

Addresses

Primary practice location

230 W Chrysler Dr
Belvidere, IL 61008-6304

Mailing address

596 Bayfield Dr
Dekalb, IL 60115-2319

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

LicenseStateTypeSpecialty
051.288974ILMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1314403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314403200000",
    "number": "1821378373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "596 BAYFIELD DR",
            "city": "DEKALB",
            "state": "IL",
            "postal_code": "601152319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 W CHRYSLER DR",
            "city": "BELVIDERE",
            "state": "IL",
            "postal_code": "610086304",
            "telephone_number": "815-544-4790",
            "fax_number": "815-547-4827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNS",
        "first_name": "BRIAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-27",
        "last_updated": "2011-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051.288974",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Belvidere, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2011; 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.