Individual provider Active NPI

Kurt Michael Bryant, DC

  • Chiropractor
  • Placentia, CA
National Provider Identifier
1174793582
Registry record updated May 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
30827 Issued in CA
Practice address
206 S Placentia Ave
Placentia, CA 92870-5710
Phone
(714) 572-9555
Fax
(714) 986-9600
NPI assigned
Mar 3, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 30827 CA Primary

Addresses

Primary practice location

206 S Placentia Ave
Placentia, CA 92870-5710

Mailing address

206 S Placentia Ave
Placentia, CA 92870-5710
Phone (714) 572-9555

Other practice location 1

3220 S Brea Canyon Rd
Suite F
Diamond Bar, CA 91765-3481
Phone (909) 598-7868

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110722000245 CA Practitioner - Chiropractic 8123186152 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

206 S Placentia Ave
Placentia, CA 92870-5710
Phone (714) 572-9555

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1204502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620691200000",
    "number": "1174793582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 S PLACENTIA AVE",
            "city": "PLACENTIA",
            "state": "CA",
            "postal_code": "928705710",
            "telephone_number": "714-572-9555",
            "fax_number": "714-986-9600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 S PLACENTIA AVE",
            "city": "PLACENTIA",
            "state": "CA",
            "postal_code": "928705710",
            "telephone_number": "714-572-9555",
            "fax_number": "714-986-9600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3220 S Brea Canyon Rd",
            "address_2": "Suite F",
            "address_purpose": "LOCATION",
            "city": "Diamond Bar",
            "state": "CA",
            "postal_code": "917653481",
            "country_code": "US",
            "telephone_number": "909-598-7868",
            "fax_number": "909-598-4428",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRYANT",
        "first_name": "KURT",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-03",
        "last_updated": "2021-05-11",
        "certification_date": "2021-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "30827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Placentia, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2021; 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.