Bruce Arthur Wraa, MT, ASCP

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

MTA22223 Issued in CA

Practice address

5255 S Cathay Way
Centennial, CO 80015-4859

Phone

(303) 693-2126

NPI assigned

Feb 12, 2009

Last updated

Feb 12, 2009By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Medical Technician

State licenses

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

{
    "created_epoch": "1234396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234396800000",
    "number": "1942449095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5255 S CATHAY WAY",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "800154859",
            "telephone_number": "303-693-2126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5255 S CATHAY WAY",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "800154859",
            "telephone_number": "303-693-2126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WRAA",
        "first_name": "BRUCE",
        "middle_name": "ARTHUR",
        "name_prefix": "Mr.",
        "credential": "MT, ASCP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-02-12",
        "last_updated": "2009-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "CA",
            "license": "MTA22223",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA LICENSED MEDICAL TECHNOLOGIST",
            "identifier": "MTA 22223",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMER. SOC. OF CLIN PATH. CERTIFIED MEDICAL TECHNOLOGIST",
            "identifier": "MT-98209",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinical Medical Laboratory in Centennial, CO
• Providers in Centennial, CO by specialty
• Clinical Medical Laboratory in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2009; 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.