Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Carson Matthew Bruner

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1063107183

Carson Matthew Bruner is an Optometry in Coldwater, Ohio. Qualified in 2023, 3 years ago. Practices with Dickman Kettler and Bruner Inc, a 6-clinician group and accepts Medicare assignment. Licensed in Ohio.

Years since qualifying
3
Licensed in
OH
In the registry since
2023
Specialties on file
2

Practice location Address checks out

201 S 2nd St
Coldwater, OH 45828-1747
Phone: (937) 417-4581
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Optometrist (primary) Taxonomy 152W00000X · Licence 7159 (OH)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1063107183
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedApril 5, 2023
Last updated in NPPESJuly 17, 2023
Certification dateJuly 17, 2023
Mailing address6050 Anna M Ave, Greenville, OH 45331-9609

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOPTOMETRY
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Dickman Kettler And Bruner Inc — 6 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Coldwater