Active NPI
Brian John Dozark, D.C.
- Chiropractor
- Brandon, SD
National Provider Identifier
1073593836
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 1033
- Practice address
- 128 E Holly Blvd
Brandon, SD 57005-1114 - Phone
- (605) 582-8800
- Fax
- (605) 582-8820
- NPI assigned
- Jan 18, 2006
- Last updated
- Oct 5, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 1033 | SD | Primary |
Addresses
Primary practice location
128 E Holly Blvd
Brandon, SD 57005-1114
Mailing address
128 E Holly Blvd
Brandon, SD 57005-1114
Phone (605) 582-8800
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4995366 | Other | SD | WELLMARK BCBS |
| 10292 | Other | SD | AVERA HEALTH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1033 | SD | MD | Surgical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mason Orth PC | Chiropractor | Current | Accepting new patients |
| Mason Orth, PC | Chiropractor | Current | Accepting new patients |
| Oahe Chiropractic and Wellness, P.C. | Chiropractor | Past | Accepting new patients |
| Chirosport Brandon, PC | Past | Accepting new patients |
Locations
3175 Sienna Dr S
Ste 105
Fargo, ND 58104
Phone (701) 451-9098
Organizations & group practices 4
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.
-
- Clinic/Center
- Brandon, SD
- NPI 1942048558
-
- Chiropractor
- Pierre, SD
- NPI 1407212673
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137542400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1349395200000",
"number": "1073593836",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "128 E HOLLY BLVD",
"city": "BRANDON",
"state": "SD",
"postal_code": "570051114",
"telephone_number": "605-582-8800",
"fax_number": "605-582-8820"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "128 E HOLLY BLVD",
"city": "BRANDON",
"state": "SD",
"postal_code": "570051114",
"telephone_number": "605-582-8800",
"fax_number": "605-582-8820"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOZARK",
"first_name": "BRIAN",
"middle_name": "JOHN",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-18",
"last_updated": "2012-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "SD",
"license": "1033",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLMARK BCBS",
"identifier": "4995366",
"state": "SD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AVERA HEALTH",
"identifier": "10292",
"state": "SD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Brandon, SD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 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.