Individual provider Active NPI

Brock Brunson, D.C.

  • Chiropractor
  • Homer, LA
National Provider Identifier
1295100360
Registry record updated Dec 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1759 Issued in LA
Practice address
727 W Main St
Homer, LA 71040-3314
Phone
(318) 927-2320
Fax
(318) 927-3090
NPI assigned
Dec 1, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 1, 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 1759 LA Primary

Addresses

Primary practice location

727 W Main St
Homer, LA 71040-3314

Mailing address

727 W Main St
Homer, LA 71040-3314
Phone (318) 927-2320

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160225000803 LA Practitioner - Chiropractic 8224333463 Reassigns benefits to 1 organization
Practice locations: Homer, LA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4707 Cypress St
West Monroe, LA 71291-7585
Phone (318) 396-5558

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1759LAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Mayfield Chriopractic West Inc Chiropractor CurrentSince Apr 9, 2018 Accepting new patients

Locations

4707 Cypress St
West Monroe, LA 71291
Phone (318) 396-5558

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1448928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1448928000000",
    "number": "1295100360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "727 W MAIN ST",
            "city": "HOMER",
            "state": "LA",
            "postal_code": "710403314",
            "telephone_number": "318-927-2320",
            "fax_number": "318-927-3090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "727 W MAIN ST",
            "city": "HOMER",
            "state": "LA",
            "postal_code": "710403314",
            "telephone_number": "318-927-2320",
            "fax_number": "318-927-3090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNSON",
        "first_name": "BROCK",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-12-01",
        "last_updated": "2015-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "LA",
            "license": "1759",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Homer, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2015; 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.