NPIMap

Organization Active NPI

Thomas a Brozovich DC PC

  • Chiropractor
  • Rock Island, IL
National Provider Identifier
1013215771
Registry record updated Mar 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038004582 Issued in IL
Legal business name
THOMAS A BROZOVICH DC PC
Practice address
2514 24TH St
Rock Island, IL 61201-5304
Phone
(309) 788-3636
Fax
(309) 788-3638
NPI assigned
Mar 4, 2011
Last updated
Mar 4, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2011

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

Authorized official

Name
Thomas A Brozovich, D.C.NPI 1811969413
Title
Owner
Phone
(309) 788-3636

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038004582 IL Primary

Addresses

Primary practice location

2514 24TH St
Rock Island, IL 61201-5304

Mailing address

2514 24TH St
Rock Island, IL 61201-5304
Phone (309) 788-3636

Other identifiers 4

IdentifierTypeStateIssuer
91262OtherIAWELLMARK
08115270OtherILBCBS ILLINOIS
05-03755MedicaidIA
038004582MedicaidIL

National Provider Directory

National Provider Directory

Locations

2514 24th St
Rock Island, IL 61201
Phone (309) 786-2200

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1299196800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1299196800000",
    "number": "1013215771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2514 24TH ST",
            "city": "ROCK ISLAND",
            "state": "IL",
            "postal_code": "612015304",
            "telephone_number": "309-788-3636",
            "fax_number": "309-788-3638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2514 24TH ST",
            "city": "ROCK ISLAND",
            "state": "IL",
            "postal_code": "612015304",
            "telephone_number": "309-788-3636",
            "fax_number": "309-788-3638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMAS A BROZOVICH DC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-04",
        "last_updated": "2011-03-04",
        "status": "A",
        "authorized_official_last_name": "BROZOVICH",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "309-788-3636",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038004582",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK",
            "identifier": "91262",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS ILLINOIS",
            "identifier": "08115270",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05-03755",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "038004582",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Island, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.