Active NPI
Daniel G Brunner, MD
- Emergency Medicine Physician
- Edgewood, KY
National Provider Identifier
1831190859
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 32330
- Practice address
- 1 Medical Village Dr
Edgewood, KY 41017-3403 - Phone
- (859) 301-5705
- Fax
- (859) 301-2022
- NPI assigned
- Aug 2, 2005
- 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 |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 32330 | KY | Primary |
Addresses
Primary practice location
1 Medical Village Dr
Edgewood, KY 41017-3403
Mailing address
PO Box 18667
Erlanger, KY 41018-0667
Phone (859) 572-3617
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0381537 | Medicaid | OH | |
| 200916720 | Medicaid | IN | |
| 64055742 | Medicaid | KY |
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
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1122940800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1506556800000",
"number": "1831190859",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 18667",
"city": "ERLANGER",
"state": "KY",
"postal_code": "410180667",
"telephone_number": "859-572-3617",
"fax_number": "859-572-2326"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 MEDICAL VILLAGE DR",
"city": "EDGEWOOD",
"state": "KY",
"postal_code": "410173403",
"telephone_number": "859-301-5705",
"fax_number": "859-301-2022"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRUNNER",
"first_name": "DANIEL",
"middle_name": "G",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-02",
"last_updated": "2017-09-28",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "KY",
"license": "32330",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0381537",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200916720",
"state": "IN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "64055742",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Edgewood, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 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.