Organization Active NPI

Brad Pluckhan, D.C. a Chiropractic Corporation

  • Chiropractor
  • Gilroy, CA
National Provider Identifier
1093042244
Registry record updated Aug 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC250920 Issued in CA
Legal business name
BRAD PLUCKHAN, D.C. A CHIROPRACTIC CORPORATION
Practice address
8060 Santa Teresa Blvd
Suite 110
Gilroy, CA 95020-3867
Phone
(408) 848-2225
Fax
(408) 842-6700
NPI assigned
Nov 9, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2012

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

Authorized official

Name
Dr. Brad J Pluckhan, D.C.NPI 1598897142
Title
President
Phone
(408) 848-2225

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X DC250920 CA Primary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X PT23508 CA

Addresses

Primary practice location

8060 Santa Teresa Blvd
Suite 110
Gilroy, CA 95020-3867

Mailing address

8060 Santa Teresa Blvd
Suite 110
Gilroy, CA 95020-3867
Phone (408) 848-2225

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091120000422 CA Part B Supplier - Clinic/Group Practice 0143369702 Receives reassigned benefits from 3 practitioners
Practice locations: Gilroy, CA

National Provider Directory

National Provider Directory

Locations

7888 Wren Ave
Ste D140
Gilroy, CA 95020
Phone (408) 848-2225

8060 Santa Teresa Blvd
Ste 110
Gilroy, CA 95020
Phone (408) 848-2225

Practitioners & affiliated clinicians

Practitioners 3

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": "1257724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1344384000000",
    "number": "1093042244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8060 SANTA TERESA BLVD",
            "address_2": "SUITE 110",
            "city": "GILROY",
            "state": "CA",
            "postal_code": "950203867",
            "telephone_number": "408-848-2225",
            "fax_number": "408-842-6700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8060 SANTA TERESA BLVD",
            "address_2": "SUITE 110",
            "city": "GILROY",
            "state": "CA",
            "postal_code": "950203867",
            "telephone_number": "408-848-2225",
            "fax_number": "408-842-6700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRAD PLUCKHAN, D.C. A CHIROPRACTIC CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-09",
        "last_updated": "2012-08-08",
        "status": "A",
        "authorized_official_last_name": "PLUCKHAN",
        "authorized_official_first_name": "BRAD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "408-848-2225",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC250920",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT23508",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilroy, CA

Sources for this page

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