Derek Paul Bruner, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

12675 Issued in TX

Practice address

1858 Keller Pkwy Ste C
Keller, TX 76248-3758

Phone

(817) 431-9911

Fax

(817) 431-3900

NPI assigned

Jul 17, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Specialty

Chiropractic

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Dynamic Performance Chiropractic of Hammond

  • Chiropractor
  • Hammond, LA
  • NPI 1457850158
  Medicare reassignment NPD
• Shelly Chiropractic LLC

  dba Peformance Chiropractic and Health

  • Chiropractor
  • Prairieville, LA
  • NPI 1679965248
  NPD (past)

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

{
    "created_epoch": "1405555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491436800000",
    "number": "1952718249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1858 KELLER PKWY STE C",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "762483758",
            "telephone_number": "817-431-9911",
            "fax_number": "817-431-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1858 KELLER PKWY STE C",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "762483758",
            "telephone_number": "817-431-9911",
            "fax_number": "817-431-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNER",
        "first_name": "DEREK",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-17",
        "last_updated": "2017-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "12675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Courtney Brower
• Andrea Brown - Brezina
• Misty Jaye Brown, DDS
• Samantha Raye Browne
• Richard Marlin Browning, M.D.
• Kacia Bruning, DPT
• Cristina Bryant, PHARMD
• Jessica Febe Bryson
• Btdi JV LLP (Touchstone Imaging Keller)
• Craig E Buchmann, DDS

• Chiropractor in Keller, TX
• Providers in Keller, TX by specialty
• Chiropractor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2017; 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.