Active NPI
Craig C. Bromley, D.C.
- Chiropractor
- Lewisburg, WV
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 834
- 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, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2007144000 | Other | NJ | AMERIHEALTH INDIVIDUAL |
| 0037593 | Other | NJ | CIGNA PPO |
| 2153085000 | Other | NJ | AMERIHEALTH GROUP |
| 3097723 | Other | NJ | AETNA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA
Enrollment records 1
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
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
| License | State | Type | Specialty |
|---|---|---|---|
| F1-0000469 | DE | MD | Chiropractor |
| 38MC00519900 | NJ | MD | Chiropractor |
| DC007362L | PA | MD | Chiropractor |
| 834 | WV | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tuck Chiropractic Corporation | Chiropractor | Current | Accepting new patients |
| Mountain View Chiropractic, PLLC | Chiropractor | Current | Accepting new patients |
| Tuck Chiropractic Corporation | Past | 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.
-
dba Tuck Chiropractic Clinic
- Chiropractor
- Blacksburg, VA
- NPI 1003987769
-
- Chiropractor
- Lewisburg, WV
- NPI 1891132791
-
dba Tuck WorkWell
- Family Medicine Physician
- Roanoke, VA
- NPI 1578155610
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.