Individual provider Active NPI

Craig C. Bromley, D.C.

  • Chiropractor
  • Lewisburg, WV
National Provider Identifier
1215984463
Registry record updated Jul 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
834 Issued in WV
Practice address
112 J D Park Rd
Suite 4
Lewisburg, WV 24901-9034
Phone
(304) 520-4988
NPI assigned
May 30, 2006
Last updated
Jul 3, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 3, 2013

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 38MC00519900 NJ
Chiropractor 111N00000X DC007362L PA
Chiropractor 111N00000X 834 WV Primary
Chiropractor 111N00000X F1-0000469 DE

Addresses

Primary practice location

112 J D Park Rd
Suite 4
Lewisburg, WV 24901-9034

Mailing address

112 J D Park Rd
Suite 4
Lewisburg, WV 24901-9034

Other identifiers 4

IdentifierTypeStateIssuer
2007144000OtherNJAMERIHEALTH INDIVIDUAL
0037593OtherNJCIGNA PPO
2153085000OtherNJAMERIHEALTH GROUP
3097723OtherNJAETNA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250220003245 VA Practitioner - Chiropractic 0042278814 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Western States College of Chiropractic, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tuck Chiropractic CorporationGroup PAC ID 0547222739, 10 clinicians

Practice addresses (Care Compare)

6206 Peters Creek Rd
Roanoke, VA 24019-4026
Phone (540) 563-0334

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F1-0000469DEMDChiropractor
38MC00519900NJMDChiropractor
DC007362LPAMDChiropractor
834WVMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Tuck Chiropractic Corporation Chiropractor CurrentSince Feb 10, 2025 Accepting new patients
Mountain View Chiropractic, PLLC Chiropractor CurrentSince May 31, 2013 Accepting new patients
Tuck Chiropractic Corporation PastSince Dec 15, 2024 Accepting new patients

Locations

301 W Main St
Bedford, VA 24523
Phone (540) 586-1105

620 N Main St
Ste 202
Blacksburg, VA 24060

6206 Peters Creek Rd
Roanoke, VA 24019
Phone (540) 563-0334

112 J D Park Rd
Ste 4
Lewisburg, WV 24901
Phone (304) 646-0181

Organizations & group practices 3

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": "1148947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372809600000",
    "number": "1215984463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 J D PARK RD",
            "address_2": "SUITE 4",
            "city": "LEWISBURG",
            "state": "WV",
            "postal_code": "249019034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 J D PARK RD",
            "address_2": "SUITE 4",
            "city": "LEWISBURG",
            "state": "WV",
            "postal_code": "249019034",
            "telephone_number": "304-520-4988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROMLEY",
        "first_name": "CRAIG",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-30",
        "last_updated": "2013-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00519900",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC007362L",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WV",
            "license": "834",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "DE",
            "license": "F1-0000469",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH INDIVIDUAL",
            "identifier": "2007144000",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA PPO",
            "identifier": "0037593",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH GROUP",
            "identifier": "2153085000",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "3097723",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewisburg, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2013; 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.