Individual provider Active NPI

Brock Martin, D.C.

  • Chiropractor
  • Fort Collins, CO
National Provider Identifier
1073058806
Registry record updated Sep 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHR.0007579 Issued in CO
Practice address
4532 McMurry Ave Unit 120
Fort Collins, CO 80525-8022
Phone
(715) 490-9529
NPI assigned
Jan 3, 2017
Last updated
Sep 23, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 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 CHR.0007579 CO Primary

Addresses

Primary practice location

4532 McMurry Ave Unit 120
Fort Collins, CO 80525-8022

Mailing address

4532 McMurry Ave Unit 120
Fort Collins, CO 80525-8022
Phone (715) 490-9529

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170405001950 CO Practitioner - Chiropractic 5991081986 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4532 McMurry Ave
Unit 120
Fort Collins, CO 80525-8022
Phone (970) 294-4150

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CHR.0007579COMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Martin Chiro Noco LLC Chiropractor CurrentSince Feb 16, 2017 Accepting new patients

Locations

4532 McMurry Ave
Unit 120
Fort Collins, CO 80525
Phone (970) 294-4150

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": "1483401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727049600000",
    "number": "1073058806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4532 MCMURRY AVE UNIT 120",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805258022",
            "telephone_number": "715-490-9529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4532 MCMURRY AVE UNIT 120",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805258022",
            "telephone_number": "715-490-9529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "BROCK",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-01-03",
        "last_updated": "2024-09-23",
        "certification_date": "2024-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CO",
            "license": "CHR.0007579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2024; 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.