Individual provider Active NPI

William P. Brown, D.C.

  • Chiropractor
  • Perrysburg, OH
National Provider Identifier
1063402055
Registry record updated Aug 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2090 Issued in OH
Practice address
13003 Eckel Junction Rd Ste 105
Perrysburg, OH 43551
Phone
(419) 874-0405
Fax
(419) 874-0427
NPI assigned
Oct 21, 2005
Last updated
Aug 15, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2090 OH Primary

Addresses

Primary practice location

13003 Eckel Junction Rd Ste 105
Perrysburg, OH 43551

Mailing address

13003 Eckel Junction Rd Ste 105
Perrysburg, OH 43551-7633
Phone (419) 874-0405

Other identifiers 9

IdentifierTypeStateIssuer
725885OtherOHFAMILY HEALTH PLAN
000000193661OtherOHANTHEM
0125993MedicaidOH
247800180005OtherOHMEDICAL MUTUAL OF OHIO
P00080570OtherOHRRB - MEDICARE
157124227OtherOHPPOM
2580173OtherOHCIGNA
341940537-00OtherOHWORKERS COMPENSATION
5349505OtherOHAETNA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040413001162 OH Practitioner - Chiropractic 3678567740 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

13003 Eckel Junction Rd
Suite 105
Perrysburg, OH 43551-7633
Phone (419) 874-0405

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2090OHMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
William P. Brown, D.C., Inc. Chiropractor CurrentSince Dec 26, 2000 Accepting new patients

Locations

13003 Eckel Junction Rd
Ste 105
Perrysburg, OH 43551
Phone (419) 874-0405

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1129852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534291200000",
    "number": "1063402055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13003 ECKEL JUNCTION RD STE 105",
            "city": "PERRYSBURG",
            "state": "OH",
            "postal_code": "435517633",
            "telephone_number": "419-874-0405",
            "fax_number": "419-874-0427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13003 ECKEL JUNCTION RD STE 105",
            "city": "PERRYSBURG",
            "state": "OH",
            "postal_code": "43551",
            "telephone_number": "419-874-0405",
            "fax_number": "419-874-0427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "WILLIAM",
        "middle_name": "P.",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-21",
        "last_updated": "2018-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "2090",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FAMILY HEALTH PLAN",
            "identifier": "725885",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000193661",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0125993",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL MUTUAL OF OHIO",
            "identifier": "247800180005",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRB - MEDICARE",
            "identifier": "P00080570",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PPOM",
            "identifier": "157124227",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "2580173",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WORKERS COMPENSATION",
            "identifier": "341940537-00",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5349505",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Perrysburg, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2018; 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.