Individual provider Active NPI

Brian Mark Shuffler, D.C.

  • Chiropractor
  • Philadelphia, PA
National Provider Identifier
1164442380
Registry record updated Sep 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC008838 Issued in PA
Practice address
1425 Arch St
YMCA Building, First Floor
Philadelphia, PA 19102-1507
Phone
(215) 557-9090
Fax
(215) 557-9089
NPI assigned
Jul 20, 2006
Last updated
Sep 9, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC00838 PA
Chiropractor 111N00000X DC008838 PA Primary

Addresses

Primary practice location

1425 Arch St
YMCA Building, First Floor
Philadelphia, PA 19102-1507

Mailing address

315 E State St
Media, PA 19063-3517
Phone (610) 566-0591

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040209000433 PA Practitioner - Chiropractic 2567356991 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1508 Paoli Pike
West Chester, PA 19380-6114
Phone (610) 696-0688

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC00838PAMDChiropractor
DC008838PAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Dennis T. Rehrig DC PC Chiropractor Past Accepting new patients
Havertown Wellness Center Chiropractor Past Accepting new patients

Organizations & group practices 3

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": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1220918400000",
    "number": "1164442380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 E STATE ST",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190633517",
            "telephone_number": "610-566-0591",
            "fax_number": "610-566-0591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 ARCH ST",
            "address_2": "YMCA BUILDING, FIRST FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191021507",
            "telephone_number": "215-557-9090",
            "fax_number": "215-557-9089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUFFLER",
        "first_name": "BRIAN",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2008-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC00838",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC008838",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2008; 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.