Organization Active NPI

Lauderdale Chiropractic Center Inc

  • Chiropractor
  • Fort Lauderdale, FL
National Provider Identifier
1033168182
Registry record updated Sep 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
LAUDERDALE CHIROPRACTIC CENTER INC
Practice address
1140 SE 3Rd Ave
Ft Lauderdale, FL 33316-1110
Phone
(954) 764-8505
Fax
(954) 467-8723
NPI assigned
May 8, 2006
Last updated
Sep 13, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2013

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

Authorized official

Name
Rick E Bruns, DCNPI 1801079272
Title
President
Phone
(954) 764-8505

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

1140 SE 3Rd Ave
Ft Lauderdale, FL 33316-1110

Mailing address

1140 SE 3Rd Ave
Ft Lauderdale, FL 33316-1110
Phone (954) 764-8505

Other identifiers 1

IdentifierTypeStateIssuer
040763600MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080404000351 FL Part B Supplier - Clinic/Group Practice 1951488626 Receives reassigned benefits from 1 practitioner
Practice locations: Fort Lauderdale, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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": "1147046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1379030400000",
    "number": "1033168182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1140 SE 3RD AVE",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333161110",
            "telephone_number": "954-764-8505",
            "fax_number": "954-467-8723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 SE 3RD AVE",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333161110",
            "telephone_number": "954-764-8505",
            "fax_number": "954-467-8723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAUDERDALE CHIROPRACTIC CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-08",
        "last_updated": "2013-09-13",
        "status": "A",
        "authorized_official_last_name": "BRUNS",
        "authorized_official_first_name": "RICK",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-764-8505",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "040763600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.