Thomas Michael Bruner
Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Heidrick, KY
NPI 1902779770 · NPPES record last updated Sep 26, 2025
Key facts
- NPI
- 1902779770
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Student in an Organized Health Care Education/Training Program 390200000X
- Practice address
- 109 Morris LN
Heidrick, KY 40949-5976 - Phone
- (606) 545-5169
- NPI assigned
- Sep 26, 2025
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | |||
| Student in an Organized Health Care Education/Training Program | 390200000X | Yes |
Addresses
Primary practice location
109 Morris LN
Heidrick, KY 40949-5976
Mailing address
109 Morris LN
Heidrick, KY 40949-5976
Phone (606) 545-5169
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 26, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.