NPIMap

Individual provider Active NPI

Bryan Joseph Capen I, D.C.

  • Chiropractor
  • South Lyon, MI
National Provider Identifier
1184727976
Registry record updated Sep 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301008720 Issued in MI
Practice address
25136 Jefferson CT
South Lyon, MI 48178-1173
Phone
(313) 333-5250
NPI assigned
Sep 7, 2006
Last updated
Sep 24, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 24, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2301008720 MI Primary
Chiropractor 111N00000X 038011440 IL

Addresses

Primary practice location

25136 Jefferson CT
South Lyon, MI 48178-1173

Mailing address

25136 Jefferson CT
South Lyon, MI 48178-1173
Phone (313) 333-5250

Other identifiers 1

IdentifierTypeStateIssuer
950H202000OtherMIBLUE CROSS BLUE SHIELD

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wheaton Medical SC Chiropractor PastSince Nov 6, 2012 Accepting new patients
Countryview Medical Center SC Chiropractor Past Accepting new patients
Countryside Medical SC Past Accepting new patients
Illinois Back and Joint PLLC Chiropractor PastSince Jan 19, 2023 Accepting new patients
Mobile Care Chiropractor Past Accepting new patients
Klapp Chiropractic Life Center, LLC Chiropractor PastSince Jun 21, 2016 Accepting new patients

Organizations & group practices 6

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": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443052800000",
    "number": "1184727976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25136 JEFFERSON CT",
            "city": "SOUTH LYON",
            "state": "MI",
            "postal_code": "481781173",
            "telephone_number": "313-333-5250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25136 JEFFERSON CT",
            "city": "SOUTH LYON",
            "state": "MI",
            "postal_code": "481781173",
            "telephone_number": "313-333-5250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAPEN",
        "first_name": "BRYAN",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "name_suffix": "I",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-07",
        "last_updated": "2015-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301008720",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038011440",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "950H202000",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Lyon, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2015; 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.