Jerry J Bruggeman (NPI# 1033161120, PAC ID# 8123079308) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1033161120 |
| PAC ID by PECOS | 8123079308 |
| Professional Enrollment ID | I20050204000334 |
| Full Name | Jerry J Bruggeman |
| Organization Legal Name | ADVANCED SENIOR CARE, INC |
| Address |
229 Karen Dr Holts Summit MO 65043-2522 |
| Phone Number | 5738968567 |
| Gender | M |
| Credential | MD |
| Medical School | UNIVERSITY OF MISSOURI, COLUMBIA SCHOOL OF MEDICINE |
| Graduation Year | 2001 |
| Primary Specialty | FAMILY MEDICINE |
| Group Practice PAC ID | 6204010846 |
| Number of Group Practice Members | 10 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 260064 | SSM HEALTH ST. MARY'S HOSPITAL-AUDRAIN |
| 260141 | UNIVERSITY OF MISSOURI HOSPITAL & CLINICS |
| 260209 | FULTON MEDICAL CENTER LLC |
| 260009 | BOTHWELL REGIONAL HEALTH CENTER |
| Address | Phone | Organization |
|---|---|---|
| 910 N College Ave, Suite 4, Columbia, MO 65201-4797 | 6366421215 | ADVANCED SENIOR CARE, INC |
| 229 Karen Dr, Holts Summit, MO 65043-2522 | 5738968567 | ADVANCED SENIOR CARE, INC |
| Organization Legal Name | ADVANCED SENIOR CARE, INC |
| Physicians | 15 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Karli R Urban | Geriatric Medicine | Advanced Senior Care, Inc | 910 N College Ave, Suite 4, Columbia, MO 65201-4797 |
| Patricia J Struby | Clinical Social Worker | Advanced Senior Care, Inc | 229 Karen Dr, Holts Summit, MO 65043-2522 |
| Harry Band Stevenson | Nurse Practitioner | Advanced Senior Care, Inc | 910 N College Ave, Suite 4, Columbia, MO 65201-4797 |
| Phu Thanh Tran | Emergency Medicine | Advanced Senior Care, Inc | 910 N College Ave, Suite 4, Columbia, MO 65201-4797 |
| Rita Denome | Clinical Social Worker | Advanced Senior Care, Inc | 910 N College Ave, Suite 4, Columbia, MO 65201-4797 |
| Jackie Dee Faber | Certified Clinical Nurse Specialist (cns) | Advanced Senior Care, Inc | 910 N College Ave, Suite 4, Columbia, MO 65201-4797 |
| Nicole J Albin | Family Medicine | Advanced Senior Care, Inc | 910 N College Ave, Suite 4, Columbia, MO 65201-4797 |
| Cayla L Malter | Clinical Social Worker | Advanced Senior Care, Inc | 910 N College Ave, Suite 4, Columbia, MO 65201-4797 |
| Cheryl L Kyle | Nurse Practitioner | Advanced Senior Care, Inc | 910 N College Ave, Suite 4, Columbia, MO 65201-4797 |
| Michael N Deloughery | Nurse Practitioner | Advanced Senior Care, Inc | 910 N College Ave, Suite 4, Columbia, MO 65201-4797 |
| Street Address |
229 KAREN DR |
| City | HOLTS SUMMIT |
| State | MO |
| Zip | 65043-2522 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Patricia J Struby | Clinical Social Worker | Advanced Senior Care, Inc | 229 Karen Dr, Holts Summit, MO 65043-2522 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Lorrie L Campbell | Family Medicine | Capital Region Medical Center | 180 Northstar Dr, Capital Region Physicians, Holts Summit, MO 65043-1123 |
| Curtis W Dyer | Family Medicine | Ssm Regional Health Services | 140 Northstar Dr, Holts Summit, MO 65043-1123 |
| Ashley Sandbothe | Nurse Practitioner | Ssm Regional Health Services | 140 Northstar Dr, Holts Summit, MO 65043-1123 |
| City | HOLTS SUMMIT |
| Zip Code | 65043 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | HOLTS SUMMIT + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Jerry J Bruggeman.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.