Organization Active NPI

Bronson Chiropractic Clinic P.C.

  • Chiropractor
  • Phoenix, AZ
National Provider Identifier
1063771368
Registry record updated May 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3217 Issued in AZ
Legal business name
BRONSON CHIROPRACTIC CLINIC P.C.
Practice address
18631 N 19TH Ave
Suite 152
Phoenix, AZ 85027-5299
Phone
(602) 789-1078
Fax
(623) 582-0997
NPI assigned
May 8, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 8, 2012

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

Authorized official

Name
Dr. Richard Frederick Bronson, D.C.
Title
Owner
Phone
(602) 789-1078

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 3217 AZ Primary

Addresses

Primary practice location

18631 N 19TH Ave
Suite 152
Phoenix, AZ 85027-5299

Mailing address

18631 N 19TH Ave
Suite 152
Phoenix, AZ 85027-5299
Phone (602) 789-1078

Other identifiers 1

IdentifierTypeStateIssuer
525834MedicaidAZ

National Provider Directory

National Provider Directory

Locations

18631 N 19th Ave
Ste 152
Phoenix, AZ 85027
Phone (602) 789-1078

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1336435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1336435200000",
    "number": "1063771368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18631 N 19TH AVE",
            "address_2": "SUITE 152",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850275299",
            "telephone_number": "602-789-1078",
            "fax_number": "623-582-0997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18631 N 19TH AVE",
            "address_2": "SUITE 152",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850275299",
            "telephone_number": "602-789-1078",
            "fax_number": "623-582-0997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRONSON CHIROPRACTIC CLINIC P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-08",
        "last_updated": "2012-05-08",
        "status": "A",
        "authorized_official_last_name": "BRONSON",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "FREDERICK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "602-789-1078",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "3217",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "525834",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2012; 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.