Individual provider Active NPI

Tyler-Brooks Arviso, DC

  • Chiropractor
  • Gallup, NM
National Provider Identifier
1174335343
Registry record updated Jan 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC-2025-0002 Issued in NM
Practice address
208 E Nizhoni Blvd
Gallup, NM 87301-5744
Phone
(505) 722-7575
NPI assigned
Jan 23, 2025
Last updated
Jan 23, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC-2025-0002 NM Primary

Addresses

Primary practice location

208 E Nizhoni Blvd
Gallup, NM 87301-5744

Mailing address

1504 Diamond Cir
Gallup, NM 87301-4900
Phone (505) 879-2449

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250131003498 NM Practitioner - Chiropractic 9032648266 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2024
Medicare assignment
May accept Medicare assignment
Group practices
Full Circle Chiropractic, PCGroup PAC ID 6901940725, 2 clinicians

Practice addresses (Care Compare)

208 E Nizhoni Blvd
Gallup, NM 87301-5744
Phone (505) 722-7575

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC-2025-0002NMMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Full Circle Chiropractic, PC Chiropractor CurrentSince Jan 27, 2025 Accepting new patients

Locations

208 E Nizhoni Blvd
Gallup, NM 87301
Phone (505) 722-7575

Organizations & group practices 1

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": "1737590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737590400000",
    "number": "1174335343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1504 DIAMOND CIR",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "873014900",
            "telephone_number": "505-879-2449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 E NIZHONI BLVD",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "873015744",
            "telephone_number": "505-722-7575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARVISO",
        "first_name": "TYLER-BROOKS",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-01-23",
        "last_updated": "2025-01-23",
        "certification_date": "2025-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NM",
            "license": "DC-2025-0002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gallup, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2025; 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.