Derek Moses Brady, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

DC011717 Issued in PA

Practice address

1009 E 38TH St
Erie, PA 16504-1843

Phone

(814) 580-8003

NPI assigned

Jan 17, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Specialty

Chiropractic

Education

Palmer College Chiropractic - Davenport, 2021

Medicare assignment

May accept Medicare assignment

Group practices

Vardy Chiropractic and Wellness ClinicsGroup PAC ID 9234160409, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Vardy Chiropractic and Wellness Clinics

  • Chiropractor
  • Wendell, NC
  • NPI 1366525149
  Medicare reassignment Care Compare group NPD
• Brady Sports Chiropractic

  • Chiropractor
  • Erie, PA
  • NPI 1811640519
  NPD Authorized official

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

{
    "created_epoch": "1642377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642377600000",
    "number": "1194476572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "919 WESCHLER AVE",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165021059",
            "telephone_number": "814-504-6938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1009 E 38TH ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165041843",
            "telephone_number": "814-580-8003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADY",
        "first_name": "DEREK",
        "middle_name": "MOSES",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-01-17",
        "last_updated": "2022-01-17",
        "certification_date": "2021-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC011717",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Michael Bozman, PHD
• Matthew R Bradley, PHARMD
• Kelia Kimesha Bradshaw, CRNP
• Brady Sports Chiropractic
• Bethany Hilterman Brady, O.D.
• Lily Brak
• Daniel Braman, PSY.D.
• Nicholas Brandau, LSW
• Emily Brant, MD, MS
• Angelika Braslavskiy

• Chiropractor in Erie, PA
• Providers in Erie, PA by specialty
• Chiropractor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2022; 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.