Individual provider Active NPI

Brian Thomas Dovorany, D.C.

  • Chiropractor
  • Green Bay, WI
National Provider Identifier
1265508873
Registry record updated Feb 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3416 Issued in WI
Practice address
2031 S Webster Ave
Suite a
Green Bay, WI 54301-2257
Phone
(920) 437-3370
Fax
(920) 437-6212
NPI assigned
Nov 27, 2006
Last updated
Feb 27, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3416 WI Primary

Addresses

Primary practice location

2031 S Webster Ave
Suite a
Green Bay, WI 54301-2257

Mailing address

163 N Broadway
Suite a
Green Bay, WI 54303-2727
Phone (920) 437-3370

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

LicenseStateTypeSpecialty
3416WIMDChiropractor

Organizations & group practices 1

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": "1164585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488153600000",
    "number": "1265508873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "163 N BROADWAY",
            "address_2": "SUITE A",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543032727",
            "telephone_number": "920-437-3370",
            "fax_number": "920-437-6212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2031 S WEBSTER AVE",
            "address_2": "SUITE A",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543012257",
            "telephone_number": "920-437-3370",
            "fax_number": "920-437-6212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOVORANY",
        "first_name": "BRIAN",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-27",
        "last_updated": "2017-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "3416",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2017; 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.