Individual provider Active NPI

Ronald C. Brown, D.C.

  • Chiropractor
  • Logansport, IN
National Provider Identifier
1124181250
Registry record updated Jan 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
482 Issued in IN
Practice address
4415 E Market St
Logansport, IN 46947-2356
Phone
(574) 753-4871
Fax
(574) 753-4871
NPI assigned
Dec 19, 2006
Sex
Male
Sole proprietor
Yes

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 and National Provider Directory roles.

Care Compare profile

Medicare Care Compare
Specialty
ChiropracticAlso: Diagnostic Radiology
Education
Palmer College Chiropractic - Davenport, 1973
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4415 E Market St
Logansport, IN 46947-2356
Phone (574) 753-4871

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
I20080708000062 IN Practitioner - ChiropracticPractitioner - Diagnostic Radiology 0244302370 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
482INMDRadiology Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Back Acres Inc. Chiropractor CurrentSince Jan 1, 2012 Accepting new patients

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 482 IN Primary
Radiology Chiropractor 111NR0200X 482 IN

Addresses

NPPES NPI Registry

Primary practice location

4415 E Market St
Logansport, IN 46947-2356

Mailing address

4415 E Market St
Logansport, IN 46947-2356
Phone (574) 753-4871

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
100070530MedicaidIN

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 6, 2012.

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325808000000",
    "number": "1124181250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4415 E MARKET ST",
            "city": "LOGANSPORT",
            "state": "IN",
            "postal_code": "469472356",
            "telephone_number": "574-753-4871",
            "fax_number": "574-753-4871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4415 E MARKET ST",
            "city": "LOGANSPORT",
            "state": "IN",
            "postal_code": "469472356",
            "telephone_number": "574-753-4871",
            "fax_number": "574-753-4871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "RONALD",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-19",
        "last_updated": "2012-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "482",
            "primary": true
        },
        {
            "code": "111NR0200X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Radiology",
            "state": "IN",
            "license": "482",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100070530",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Logansport, IN

Sources for this page

Verify at the official NPI Registry.