Benjamin Robert Brown, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

038.013195 Issued in IL

Practice address

9449 Olive Blvd
Olivette, MO 63132-3130

Phone

(314) 432-2444

NPI assigned

May 28, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MO, IL2 enrollments

Enrollment records 2

Specialty

Chiropractic

Education

Logan College of Chiropractic, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Premier Rehab LTD 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Premier Rehab, LTD

  • Rehabilitation Chiropractor
  • Swansea, IL
  • NPI 1700953924

  IL

  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1495929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1104354612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4460 N ILLINOIS ST STE 5",
            "city": "SWANSEA",
            "state": "IL",
            "postal_code": "622261899",
            "telephone_number": "618-744-7314",
            "fax_number": "618-257-3291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9449 OLIVE BLVD",
            "city": "OLIVETTE",
            "state": "MO",
            "postal_code": "631323130",
            "telephone_number": "314-432-2444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "BENJAMIN",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-05-28",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2017015799",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038.013195",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Alicia Christine Broshuis, P.T.
• Maleah Brotherton
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• Alexandria Bryant
• Elma Bumbulovic, RBT
• Hailey Burke, RBT
• Shelly Lynne Byndom, LCSW

• All providers in Olivette, MO
• Chiropractor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.