Active NPI
Dustin Jacob Brake, D.C.
- Chiropractor
- Lawrence, KS
National Provider Identifier
1265742258
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 01-05351
- Practice address
- 3120 Mesa Way
Suite a
Lawrence, KS 66049-4200 - Phone
- (785) 842-7325
- Fax
- (785) 842-7329
- NPI assigned
- Oct 8, 2010
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 01-05351 | KS | Primary |
Addresses
Primary practice location
3120 Mesa Way
Suite a
Lawrence, KS 66049-4200
Mailing address
2300 Wakarusa Dr
Apt G6
Lawrence, KS 66047-3353
Phone (785) 218-8539
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01-05351 | KS | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brake Chiropractic LLC | Chiropractor | Past | Accepting new patients |
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.
-
- Chiropractor
- Lawrence, KS
- NPI 1811292568
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1286496000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1294617600000",
"number": "1265742258",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2300 WAKARUSA DR",
"address_2": "APT G6",
"city": "LAWRENCE",
"state": "KS",
"postal_code": "660473353",
"telephone_number": "785-218-8539"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3120 MESA WAY",
"address_2": "SUITE A",
"city": "LAWRENCE",
"state": "KS",
"postal_code": "660494200",
"telephone_number": "785-842-7325",
"fax_number": "785-842-7329"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRAKE",
"first_name": "DUSTIN",
"middle_name": "JACOB",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-10-08",
"last_updated": "2011-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "KS",
"license": "01-05351",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lawrence, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.