Active NPI
Bart Allen Brundage, DC
- Chiropractor
- Phelps, NY
National Provider Identifier
1184700502
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 0097511
- Practice address
- 8 Banta St
Suite 406
Phelps, NY 14532 - Phone
- (315) 548-2225
- Fax
- (716) 672-8711
- NPI assigned
- Oct 27, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 0097511 | NY | Primary |
Addresses
Primary practice location
8 Banta St
Suite 406
Phelps, NY 14532
Mailing address
8 Banta St
Suite 406
Phelps, NY 14532
Phone (315) 548-2225
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
| License | State | Type | Specialty |
|---|---|---|---|
| 0097511 | NY | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161907200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1184700502",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8 BANTA ST",
"address_2": "SUITE 406",
"city": "PHELPS",
"state": "NY",
"postal_code": "14532",
"telephone_number": "315-548-2225",
"fax_number": "716-672-8711"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8 BANTA ST",
"address_2": "SUITE 406",
"city": "PHELPS",
"state": "NY",
"postal_code": "14532",
"telephone_number": "315-548-2225",
"fax_number": "716-672-8711"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRUNDAGE",
"first_name": "BART",
"middle_name": "ALLEN",
"name_prefix": "Mr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "NY",
"license": "0097511",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Phelps, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.