Individual provider Active NPI

Robin Bruck, D.C.

  • Chiropractor
  • Manchester, NH
National Provider Identifier
1093852857
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
0041289 Issued in NH
Practice address
765 S Main St
Suite 201
Manchester, NH 03102-5141
Phone
(603) 626-3900
Fax
(603) 626-3908
NPI assigned
Jan 31, 2007
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 0041289 NH Primary

Addresses

Primary practice location

765 S Main St
Suite 201
Manchester, NH 03102-5141

Mailing address

765 S Main St
Suite 201
Manchester, NH 03102-5141
Phone (603) 626-3900

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050823000103 NH Practitioner - Chiropractic 1355372137 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chiropractic Associates of Bedford, P.a.Group PAC ID 0143252767, 3 clinicians

Practice addresses (Care Compare)

765 S Main St
Suite 201
Manchester, NH 03102-5141
Phone (603) 626-3900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0041289NHMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Chiropractic Associates of Bedford, P.a. Chiropractor CurrentSince May 30, 2008 Accepting new patients

Locations

765 S Main St
Ste 201
Manchester, NH 03102
Phone (603) 626-3900

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": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1093852857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "765 S MAIN ST",
            "address_2": "SUITE 201",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031025141",
            "telephone_number": "603-626-3900",
            "fax_number": "603-626-3908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "765 S MAIN ST",
            "address_2": "SUITE 201",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031025141",
            "telephone_number": "603-626-3900",
            "fax_number": "603-626-3908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUCK",
        "first_name": "ROBIN",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-31",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NH",
            "license": "0041289",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.