Individual provider Active NPI

Brian L Glaus, D.C.

  • Chiropractor
  • Davenport, IA
National Provider Identifier
1144230376
Registry record updated Apr 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038009702 Issued in IL
Practice address
2220 E 53Rd St
Davenport, IA 52807-2704
Phone
(563) 355-3100
Fax
(888) 773-3960
NPI assigned
Aug 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038009702 IL Primary

Addresses

Primary practice location

2220 E 53Rd St
Davenport, IA 52807-2704

Mailing address

2220 E 53Rd St
Davenport, IA 52807-2704
Phone (563) 355-3100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20041030000082 IL Practitioner - Chiropractic 3375535719
I20050607001089 IA Practitioner - Chiropractic 3375535719 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Quad City Wellness Group, LLCGroup PAC ID 4981971264, 2 clinicians

Practice addresses (Care Compare)

2220 E 53Rd St
Davenport, IA 52807-2704
Phone (563) 355-3100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
06500IAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Quad City Wellness Group, LLC Chiropractor CurrentSince Apr 17, 2017 Accepting new patients
Cedar Rapids Chiropractic LLC Chiropractor Past Accepting new patients
Alpine Spine & Rehabilitation Group Chiropractor PastSince Feb 14, 2005 Accepting new patients
Wilson Family Chiropractic Center Inc. Chiropractor Past Accepting new patients

Locations

2220 E 53rd St
Davenport, IA 52807
Phone (563) 355-3100

Organizations & group practices 4

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": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493078400000",
    "number": "1144230376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2220 E 53RD ST",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528072704",
            "telephone_number": "563-355-3100",
            "fax_number": "888-773-3960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2220 E 53RD ST",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528072704",
            "telephone_number": "563-355-3100",
            "fax_number": "888-773-3960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLAUS",
        "first_name": "BRIAN",
        "middle_name": "L",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-09",
        "last_updated": "2017-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038009702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davenport, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2017; 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.