Amy Bruggemann, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209005238 Issued in IL

Practice address

40 N 64TH St
Belleville, IL 62223-3808

Phone

(618) 397-8400

NPI assigned

Jun 21, 2005

Last updated

Dec 2, 2014By the provider in NPPES

Sex

Female

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 IL, MO2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Interoperability endpoints

• Direct secure messaging: abruggemann@sw.ssdirect.aprima.com

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.

• Specialized Wound Management LLC

  dba Specialized Wound Management

  • Adult Health Nurse Practitioner
  • Chesterfield, MO
  • NPI 1962430157

  IL

  Medicare reassignment

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

{
    "created_epoch": "1119312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417478400000",
    "number": "1972509339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 EXECUTIVE DRIVE",
            "address_2": "SUITE 104",
            "city": "ST. CHARLES",
            "state": "MO",
            "postal_code": "63303",
            "telephone_number": "888-811-4677",
            "fax_number": "800-605-8906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 N 64TH ST",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622233808",
            "telephone_number": "618-397-8400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUGGEMANN",
        "first_name": "AMY",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-21",
        "last_updated": "2014-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209005238",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Clay Brown Jr., MD
• Titianna Chloe Brown, APRN
• Willie Lee Brown, D.P.M.
• Amy Lynn Bruce, MS CCC-SLP
• Matthew James Bruening, CRNA
• Rachel Brunnworth
• Kyle Brunsmann, MSR, LMT
• Shelia Bryson, DDS
• Christopher Kenneth Buchheit, PHARM D
• Lucas Kyle Buckley, MD

• Family Nurse Practitioner in Belleville, IL
• Providers in Belleville, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.