Brian T Clark, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

979 Issued in AL

Practice address

5175 Moores Mill Road
Huntsville, AL 35811

Phone

(256) 859-0440

Fax

(256) 849-0388

NPI assigned

Sep 12, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Chase Chiropractic Center

  • Chiropractor
  • Huntsville, AL
  • NPI 1902900475
  NPD (past) Authorized official

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

{
    "created_epoch": "1158019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432857600000",
    "number": "1104920669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5175 MOORES MILL ROAD",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "35811",
            "telephone_number": "256-859-0440",
            "fax_number": "256-859-0388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5175 MOORES MILL ROAD",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "35811",
            "telephone_number": "256-859-0440",
            "fax_number": "256-849-0388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "BRIAN",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-12",
        "last_updated": "2015-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AL",
            "license": "979",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS&BLUE SHIELD",
            "identifier": "051070543",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sam J Citrano Jr., DMD
• Kyle Anthony Claborn, CRNP
• Gregory Walter Clardy, OD
• Alyssa Clare
• Ariel Clark
• Deborah Neir Clark, RPH
• Doris Elizabeth Clark, CRNP
• James W Clark Jr., LPC
• Jessica Autumn Clark
• John A.H. Clark, M.D.

• Chiropractor in Huntsville, AL
• Providers in Huntsville, AL by specialty
• Chiropractor in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2015; 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.