Individual provider Active NPI

Brandon Matthew Fitch, D.C.

  • Chiropractor
  • Bentonville, AR
National Provider Identifier
1013213271
Registry record updated Jun 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
15750 Issued in AR
Practice address
211 NE a St
Bentonville, AR 72712-5315
Phone
(479) 273-9715
NPI assigned
Feb 7, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 3, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 15750 AR Primary

Addresses

Primary practice location

211 NE a St
Bentonville, AR 72712-5315

Mailing address

211 NE a St
Bentonville, AR 72712-5315
Phone (479) 273-9715

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130315000369 AR Practitioner - Chiropractic 6204008972 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2009
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

113 NW 2ND St
Bentonville, AR 72712-5232

3902 E Central Ave
Bentonville, AR 72712-3141
Phone (479) 273-9715

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15750ARMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Rice Chiropractic Clinic P.a. Chiropractor PastSince Jan 30, 2013 Accepting new patients
Made to Move Physical Therapy LLC PastSince Dec 15, 2024 Accepting new patients

Networks

  • MS PPO D-SNP
  • MS PPO
  • TN PPO
  • devoted network organization-734447cc-691b-4aa7-a112-9c9c8698dcc9
  • TN PPO C-SNP
  • MS PPO C-SNP
  • devoted network organization-27eb9117-6975-449a-a7ad-909243995ddc

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1297036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370217600000",
    "number": "1013213271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 NE A ST",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727125315",
            "telephone_number": "479-273-9715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 NE A ST",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727125315",
            "telephone_number": "479-273-9715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITCH",
        "first_name": "BRANDON",
        "middle_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-02-07",
        "last_updated": "2013-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AR",
            "license": "15750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bentonville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2013; 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.