Organization Active NPI

Corey S Bruce MD LTD

  • Obstetrics & Gynecology Physician
  • Phoenix, AZ
National Provider Identifier
1942216585
Registry record updated May 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
29104 Issued in AZ
Legal business name
COREY S BRUCE MD LTD
Practice address
530 E Thomas Rd
Phoenix, AZ 85012-3204
Phone
(602) 351-2229
Fax
(602) 351-1500
NPI assigned
Aug 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 24, 2012

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

Authorized official

Name
Dr. Corey Scott Bruce, M.D.
Title
President/Physician
Phone
(602) 351-2229

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X 29104 AZ Primary

Addresses

Primary practice location

530 E Thomas Rd
Phoenix, AZ 85012-3204

Mailing address

530 E Thomas Rd
Phoenix, AZ 85012-3204
Phone (602) 351-2229

Other identifiers 1

IdentifierTypeStateIssuer
550956MedicaidAZ

National Provider Directory

National Provider Directory

Locations

500 W Thomas Rd
Ste 440
Phoenix, AZ 85013
Phone (602) 241-1512

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337817600000",
    "number": "1942216585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 E THOMAS RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850123204",
            "telephone_number": "602-351-2229",
            "fax_number": "602-351-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 E THOMAS RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850123204",
            "telephone_number": "602-351-2229",
            "fax_number": "602-351-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COREY S BRUCE MD LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-01",
        "last_updated": "2012-05-24",
        "status": "A",
        "authorized_official_last_name": "BRUCE",
        "authorized_official_first_name": "COREY",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "PRESIDENT/PHYSICIAN",
        "authorized_official_telephone_number": "602-351-2229",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "AZ",
            "license": "29104",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "550956",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2012; 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.