Individual provider Active NPI

Brandon J Smith, D.C.

  • Chiropractor
  • New Brighton, PA
National Provider Identifier
1063721256
Registry record updated May 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC010302 Issued in PA
Practice address
440 Constitution Blvd
New Brighton, PA 15066-3107
Phone
(724) 888-6853
Fax
(724) 293-0040
NPI assigned
Oct 5, 2010
Last updated
May 13, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC010302 PA Primary

Addresses

Primary practice location

440 Constitution Blvd
New Brighton, PA 15066-3107

Mailing address

440 Constitution Blvd
New Brighton, PA 15066-3107
Phone (724) 888-6853

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240625001980 PA Practitioner - Chiropractic 3870808421

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC010302PAMDChiropractor

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": "1286236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715558400000",
    "number": "1063721256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 CONSTITUTION BLVD",
            "city": "NEW BRIGHTON",
            "state": "PA",
            "postal_code": "150663107",
            "telephone_number": "724-888-6853",
            "fax_number": "724-293-0040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 CONSTITUTION BLVD",
            "city": "NEW BRIGHTON",
            "state": "PA",
            "postal_code": "150663107",
            "telephone_number": "724-888-6853",
            "fax_number": "724-293-0040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "BRANDON",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-10-05",
        "last_updated": "2024-05-13",
        "certification_date": "2024-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC010302",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Brighton, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2024; 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.