Individual provider Active NPI

Danielle M Bruggemann, PA-C

  • Physician Assistant
  • Olathe, KS
National Provider Identifier
1821536772
Registry record updated Jul 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
15-02634 Issued in KS
Practice address
20333 W 151St St
Olathe, KS 66061-5350
Phone
(913) 588-1227
NPI assigned
Feb 10, 2017
Last updated
Jul 21, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 15-02634 KS Primary

Addresses

Primary practice location

20333 W 151St St
Olathe, KS 66061-5350

Mailing address

5555 Macedonia Rd # L42
Jonesboro, AR 72401-8195
Phone (480) 231-1147

Other practice location 1

4802 E Johnson Ave
Jonesboro, AR 72401-8413
Phone (870) 936-1000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230118001885 KS Practitioner - Physician Assistant 9537438494 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
15-02634KSMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Kansas University Physicians, Inc. CurrentSince Oct 1, 2025 Accepting new patients

Locations

20333 W 151st St
Olathe, KS 66061
Phone (888) 960-1393

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": "1486684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753056000000",
    "number": "1821536772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5555 MACEDONIA RD # L42",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724018195",
            "telephone_number": "480-231-1147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20333 W 151ST ST",
            "city": "OLATHE",
            "state": "KS",
            "postal_code": "660615350",
            "telephone_number": "913-588-1227"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4802 E Johnson Ave",
            "address_purpose": "LOCATION",
            "city": "Jonesboro",
            "state": "AR",
            "postal_code": "724018413",
            "country_code": "US",
            "telephone_number": "870-936-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRUGGEMANN",
        "first_name": "DANIELLE",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-10",
        "last_updated": "2025-07-21",
        "certification_date": "2025-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KS",
            "license": "15-02634",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olathe, KS

Sources for this page

Verify at the official NPI Registry.