Individual provider Active NPI

Bryan H McDonald, DC

  • Chiropractor
  • Tuscaloosa, AL
National Provider Identifier
1104860766
Registry record updated Dec 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2082 Issued in AL
Practice address
1800 McFarland Blvd E,
Suite 340
Tuscaloosa, AL 35404-5882
Phone
(205) 345-8102
Fax
(205) 263-6478
NPI assigned
Jun 15, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 21, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2082 AL Primary

Addresses

Primary practice location

1800 McFarland Blvd E,
Suite 340
Tuscaloosa, AL 35404-5882

Mailing address

1800 McFarland Blvd E,
Suite 340
Tuscaloosa, AL 35404-5882
Phone (205) 345-8102

Other identifiers 1

IdentifierTypeStateIssuer
51527164OtherALBLUE CROSS BLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040421001759 AL Practitioner - Chiropractic 4688660095 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spine and Sport Chiropractic, IncGroup PAC ID 6901833383, 4 clinicians

Practice addresses (Care Compare)

1435 2ND CT E
Tuscaloosa, AL 35401-3276
Phone (205) 345-8102

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2082ALMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Spine & Sport Chiropractic, Inc Chiropractor CurrentSince Apr 4, 2005 Accepting new patients
Skelton Chiropractic Center, Inc Chiropractor PastSince Mar 4, 2017 Accepting new patients
Norris Chiropractic LLC Chiropractor Past Accepting new patients

Locations

1800 McFarland Blvd E
Ste 340
Tuscaloosa, AL 35404
Phone (205) 345-8102

1435 2nd Ct E
Tuscaloosa, AL 35401
Phone (205) 345-8102

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450656000000",
    "number": "1104860766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 MCFARLAND BLVD E,",
            "address_2": "SUITE 340",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354045882",
            "telephone_number": "205-345-8102",
            "fax_number": "205-263-6478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 MCFARLAND BLVD E,",
            "address_2": "SUITE 340",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354045882",
            "telephone_number": "205-345-8102",
            "fax_number": "205-263-6478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONALD",
        "first_name": "BRYAN",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2015-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AL",
            "license": "2082",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "51527164",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tuscaloosa, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2015; 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.