NPIMap

Organization Active NPI

GB Enterprises LLC

  • Chiropractor
  • Elkhorn, NE
National Provider Identifier
1124672860
Registry record updated Oct 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
GB ENTERPRISES LLC
Practice address
18924 Evans St.
Suite 105
Elkhorn, NE 68022
Phone
(531) 466-8611
NPI assigned
Jul 31, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2019

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

Authorized official

Name
Mr. Bryan James Mack, DCNPI 1538266432
Title
Chiropractor
Phone
(531) 466-8611

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

18924 Evans St.
Suite 105
Elkhorn, NE 68022

Mailing address

18924 Evans St
Suite 105
Elkhorn, NE 68022
Phone (531) 466-8611

Other names 1

  • Mack Family Chiropractic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191125001613 NE Part B Supplier - Clinic/Group Practice 3173956570 Receives reassigned benefits from 3 practitioners
Practice locations: Omaha, NE; Elkhorn, NE

National Provider Directory

National Provider Directory

Locations

18924 Evans St
Ste 105
Elkhorn, NE 68022
Phone (531) 466-8611

10177 S 168th Ave
Ste 105
Omaha, NE 68136
Phone (531) 867-3822

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1564531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571011200000",
    "number": "1124672860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18924 EVANS ST",
            "address_2": "SUITE 105",
            "city": "ELKHORN",
            "state": "NE",
            "postal_code": "68022",
            "telephone_number": "531-466-8611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18924 EVANS ST.",
            "address_2": "SUITE 105",
            "city": "ELKHORN",
            "state": "NE",
            "postal_code": "68022",
            "telephone_number": "531-466-8611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GB ENTERPRISES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-31",
        "last_updated": "2019-10-14",
        "status": "A",
        "authorized_official_last_name": "MACK",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "531-466-8611",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mack Family Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mack Family Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Elkhorn, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2019; 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.