NPIMap

Individual provider Active NPI

Karen H Bruce, M.D.

  • Family Medicine Physician
  • Collins, MS
National Provider Identifier
1942267281
Registry record updated Aug 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
18675 Issued in MS
Practice address
704 S 5TH St
Collins, MS 39428-4147
Phone
(601) 765-4414
Fax
(601) 765-9141
NPI assigned
Apr 28, 2006
Last updated
Aug 11, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 11, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 18675 MS Primary

Addresses

Primary practice location

704 S 5TH St
Collins, MS 39428-4147

Mailing address

415 S 28TH Ave
Hattiesburg, MS 39401-7246
Phone (601) 765-4414

Other identifiers 1

IdentifierTypeStateIssuer
00725822MedicaidMS

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kbruce41110@directpatientrecord.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050615000637 MS Practitioner - Family PracticePractitioner - Emergency Medicine 9436193422 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Emergency Medicine
Education
University of Mississippi School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hattiesburg Clinic PAGroup PAC ID 5193706794, 525 clinicians
Forrest County General HospitalGroup PAC ID 1052397767, 107 clinicians

Practice addresses (Care Compare)

415 S 28TH Ave
Hattiesburg, MS 39401-7246
Phone (601) 264-6000

6051 US Hwy 49 S
Hattiesburg, MS 39401-7200
Phone (601) 288-7000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Forrest County General Hospital CurrentSince Oct 6, 2018 Accepting new patients
Forrest County General Hospital CurrentSince Oct 6, 2018 Accepting new patients
Forrest County General Hospital Current Accepting new patients
Hattiesburg Clinic PA CurrentSince Jun 18, 2014 Accepting new patients
Hattiesburg Clinic, PA CurrentSince Jun 18, 2014 Accepting new patients
Hattiesburg Clinic, PA Past Accepting new patients
Hattiesburg Clinic PA Family Medicine Past Accepting new patients
Smith County LTC, LLC Past Accepting new patients

Locations

704 S 5th St
Collins, MS 39428
Phone (601) 765-4414

2117 Broadway Dr
Hattiesburg, MS 39402
Phone (601) 288-8050

415 S 28th Ave
Hattiesburg, MS 39401
Phone (601) 261-3606

6051 U S Highway 49
Hattiesburg, MS 39401
Phone (601) 288-2690

Organizations & group practices 8

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.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1146182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597104000000",
    "number": "1942267281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 S 28TH AVE",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394017246",
            "telephone_number": "601-765-4414",
            "fax_number": "601-579-5240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "704 S 5TH ST",
            "city": "COLLINS",
            "state": "MS",
            "postal_code": "394284147",
            "telephone_number": "601-765-4414",
            "fax_number": "601-765-9141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUCE",
        "first_name": "KAREN",
        "middle_name": "H",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-28",
        "last_updated": "2020-08-11",
        "certification_date": "2020-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "18675",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00725822",
            "state": "MS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kbruce41110@directpatientrecord.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "704 S 5th St",
            "city": "Collins",
            "state": "MS",
            "country_code": "US",
            "postal_code": "394284147",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Collins, MS

Sources for this page

Verify at the official NPI Registry.