Organization Active NPI

Bronson Chiropractic Clinic, P.C.

  • Chiropractor
  • Independence, MO
National Provider Identifier
1154473338
Registry record updated Aug 2, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
BRONSON CHIROPRACTIC CLINIC, P.C.
Practice address
4409 S Noland Rd
Independence, MO 64055-4742
Phone
(816) 373-7727
Fax
(816) 373-5757
NPI assigned
Jan 17, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2007

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

Authorized official

Name
Mr. Tim O Bronson, D.C.NPI 1851580591
Title
Owner
Phone
(816) 373-7727

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 SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

4409 S Noland Rd
Independence, MO 64055-4742

Mailing address

4409 S Noland Rd
Independence, MO 64055-4742
Phone (816) 373-7727

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111215000824 MO Part B Supplier - Clinic/Group Practice 5193990323 Receives reassigned benefits from 1 practitioner
Practice locations: Independence, MO

National Provider Directory

National Provider Directory

Locations

4409 S Noland Rd
Apt B
Independence, MO 64055
Phone (816) 373-7727

4405 S Noland Rd
Ste A
Independence, MO 64055
Phone (816) 373-7727

Practitioners & affiliated clinicians

Practitioners 1

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": "1168992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186012800000",
    "number": "1154473338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4409 S NOLAND RD",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640554742",
            "telephone_number": "816-373-7727",
            "fax_number": "816-373-5757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4409 S NOLAND RD",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640554742",
            "telephone_number": "816-373-7727",
            "fax_number": "816-373-5757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRONSON CHIROPRACTIC CLINIC, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-17",
        "last_updated": "2007-08-02",
        "status": "A",
        "authorized_official_last_name": "BRONSON",
        "authorized_official_first_name": "TIM",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "816-373-7727",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Independence, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2007; 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.