Individual provider Active NPI

Bradley Allen Borne, DC

  • Chiropractor
  • New York, NY
National Provider Identifier
1174715585
Registry record updated Sep 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
012417 Issued in NY
Practice address
883 Ave of the Americas
Golf & Body Nyc
New York, NY 10001
Phone
(212) 244-2626
Fax
(212) 244-2663
NPI assigned
Aug 10, 2007
Last updated
Sep 30, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 012417 NY Primary

Addresses

Primary practice location

883 Ave of the Americas
Golf & Body Nyc
New York, NY 10001

Mailing address

883 Ave of the Americas
Golf & Body Nyc
New York, NY 10001
Phone (212) 244-2626

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
012417NYMDMental Health Counselor
4004WIMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1186704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380499200000",
    "number": "1174715585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "883 AVE OF THE AMERICAS",
            "address_2": "GOLF & BODY NYC",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10001",
            "telephone_number": "212-244-2626",
            "fax_number": "212-244-2663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "883 AVE OF THE AMERICAS",
            "address_2": "GOLF & BODY NYC",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10001",
            "telephone_number": "212-244-2626",
            "fax_number": "212-244-2663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORNE",
        "first_name": "BRADLEY",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-10",
        "last_updated": "2013-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "012417",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.