Individual provider Active NPI

Brian Joseph Brockman, D. C.

  • Chiropractor
  • Omaha, NE
National Provider Identifier
1275524076
Registry record updated Feb 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
906 Issued in NE
Practice address
11322 Q St
Omaha, NE 68137-3679
Phone
(402) 331-3480
Fax
(402) 592-0316
NPI assigned
Oct 31, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 5, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 906 NE Primary

Addresses

Primary practice location

11322 Q St
Omaha, NE 68137-3679

Mailing address

11322 Q St
Omaha, NE 68137-3679
Phone (402) 331-3480

Other identifiers 4

IdentifierTypeStateIssuer
350039898OtherNERAILROAD MEDICARE
71060152200MedicaidNE
36644OtherNEBLUE CROSS BLUE SHIELD
12519OtherNEMIDLANDS CHOICE

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
906NEMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Rethwisch Family Chiropractic, P.C. Chiropractor Past Accepting new patients
Active Solutions Chiropractic, P.C. Chiropractor Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1130716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423094400000",
    "number": "1275524076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11322 Q ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681373679",
            "telephone_number": "402-331-3480",
            "fax_number": "402-592-0316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11322 Q ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681373679",
            "telephone_number": "402-331-3480",
            "fax_number": "402-592-0316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCKMAN",
        "first_name": "BRIAN",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "D. C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-31",
        "last_updated": "2015-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NE",
            "license": "906",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "350039898",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "71060152200",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "36644",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDLANDS CHOICE",
            "identifier": "12519",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2015; 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.