Broghan James Reilly, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

4512-012 Issued in WI

Practice address

3032 Commercial Blvd
Chippewa Falls, WI 54729-5078

Phone

(715) 723-2892

NPI assigned

Jun 18, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Specialty

Chiropractic

Education

Logan College of Chiropractic, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Reilly Chiropractic

  • Chiropractor
  • Chippewa Falls, WI
  • NPI 1518268655
  Medicare reassignment NPD Authorized official
• Stucky Chiropractic Proadjuster of Lake Hallie, SC

  • Chiropractor
  • Chippewa Falls, WI
  • NPI 1043407901
  NPD (past)

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

{
    "created_epoch": "1245283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568073600000",
    "number": "1083841860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4751 W PARK AVE",
            "city": "CHIPPEWA FALLS",
            "state": "WI",
            "postal_code": "547292752",
            "telephone_number": "715-723-2892",
            "fax_number": "715-723-3540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3032 COMMERCIAL BLVD",
            "city": "CHIPPEWA FALLS",
            "state": "WI",
            "postal_code": "547295078",
            "telephone_number": "715-723-2892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REILLY",
        "first_name": "BROGHAN",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-18",
        "last_updated": "2019-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "4512-012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ron R Ritchie
• River Valley Pediatric Dental Specialists
• Terri Roberts, NP
• Rockwell Home Management, LLC

• Chiropractor in Chippewa Falls, WI
• Providers in Chippewa Falls, WI by specialty
• Chiropractor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2019; 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.