Bruce Dale Pauls, PT,MS,ATC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

0769 Issued in IA

Practice address

616 W Platt St
Maquoketa, IA 52060-2118

Phone

(563) 652-4364

Fax

(563) 652-6818

NPI assigned

Jun 13, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

University of Iowa, RJ & L Carver College of Medicine, 1971

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Physical and Sports Services PC

  • Physical Therapist
  • Maquoketa, IA
  • NPI 1447752142
  Medicare reassignment NPD

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

{
    "created_epoch": "1118620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192060800000",
    "number": "1922003359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "616 W PLATT ST",
            "city": "MAQUOKETA",
            "state": "IA",
            "postal_code": "520602118",
            "telephone_number": "563-652-4364",
            "fax_number": "563-652-6818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "616 W PLATT ST",
            "city": "MAQUOKETA",
            "state": "IA",
            "postal_code": "520602118",
            "telephone_number": "563-652-4364",
            "fax_number": "563-652-6818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAULS",
        "first_name": "BRUCE",
        "middle_name": "DALE",
        "name_prefix": "Mr.",
        "credential": "PT,MS,ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-13",
        "last_updated": "2007-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "0769",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IA",
            "license": "00082",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0199000",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Matthew Charles Osterhaus, PHARMACIST
• William Henry Otteman, D.O.
• Clyde Daniel Overturff, DDS
• Pamela Severson Counseling LLC
• Brent Dale Pauls, D.C.
• Eric Scott Petersen, D.O.
• Physical and Sports Services PC
• Nicole Powers, NP
• Michelle Ann Prull, RPH
• Robert Taylor Reed, PHARM.D.

• Physical Therapist in Maquoketa, IA
• Providers in Maquoketa, IA by specialty
• Physical Therapist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2007; 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.