Individual provider Active NPI

Spencer Reece Brauchla, DC

  • Chiropractor
  • Laotto, IN
National Provider Identifier
1164053773
Registry record updated Feb 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
08003146A Issued in IN
Practice address
6265 E 400 S
Laotto, IN 46763-9772
Phone
(260) 318-5285
NPI assigned
Feb 1, 2020
Last updated
Feb 1, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 1, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 08003146A IN Primary

Addresses

Primary practice location

6265 E 400 S
Laotto, IN 46763-9772

Mailing address

6265 E 400 S
Laotto, IN 46763-9772
Phone (260) 318-5285

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210312000186 IN Practitioner - Chiropractic 7012323249 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2019
Medicare assignment
May accept Medicare assignment
Group practices
Crossroads Wellness Center, LLCGroup PAC ID 6406195593, 5 clinicians
Neighborhood Health Clinics IncGroup PAC ID 8022926294, 18 clinicians

Practice addresses (Care Compare)

12812 Coldwater Rd
Suite 101
Fort Wayne, IN 46845-9516
Phone (260) 445-8389

1717 S Calhoun St
Fort Wayne, IN 46802-5257

1721 S Calhoun St
Neighborhood Health Clinics Inc
Fort Wayne, IN 46802-5257
Phone (260) 458-2641

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
08003146AINMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Burns Physical Therapy and Wellness Company CurrentSince Aug 30, 2023 Accepting new patients
Neighborhood Health Clinics, Inc CurrentSince May 9, 2025 Accepting new patients
Crossroads Wellness Center, LLC Chiropractor CurrentSince Aug 30, 2023 Accepting new patients
Neighborhood Health Clinics, Inc CurrentSince May 9, 2025 Accepting new patients

Locations

12812 Coldwater Rd
#101
Fort Wayne, IN 46845
Phone (260) 445-8389

1717 S Calhoun St
Fort Wayne, IN 46802
Phone (260) 458-2641

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1580515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580515200000",
    "number": "1164053773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6265 E 400 S",
            "city": "LAOTTO",
            "state": "IN",
            "postal_code": "467639772",
            "telephone_number": "260-318-5285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6265 E 400 S",
            "city": "LAOTTO",
            "state": "IN",
            "postal_code": "467639772",
            "telephone_number": "260-318-5285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAUCHLA",
        "first_name": "SPENCER",
        "middle_name": "REECE",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-02-01",
        "last_updated": "2020-02-01",
        "certification_date": "2020-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "08003146A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laotto, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2020; 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.