Individual provider Active NPI

Bradley M Johnson, D.C.

  • Chiropractor
  • Santa Barbara, CA
National Provider Identifier
1295822500
Registry record updated Jan 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC19858 Issued in CA
Practice address
351 Hitchcock Way
B120
Santa Barbara, CA 93105-4016
Phone
(805) 685-8400
Fax
(805) 569-2121
NPI assigned
Oct 6, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 24, 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 DC19858 CA Primary

Addresses

Primary practice location

351 Hitchcock Way
B120
Santa Barbara, CA 93105-4016

Mailing address

351 Hitchcock Way
# B120
Santa Barbara, CA 93105-4016
Phone (805) 685-8400

Other identifiers 2

IdentifierTypeStateIssuer
DC19858OtherCHIROPRACTIC LICENSE
DC0198580OtherCABLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040128001182 CA Practitioner - Chiropractic 6507769403 Practice locations: Santa Barbara, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC19858CAMDChiropractor
19858CAMDPeriodontist

NPI Registry JSON

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485216000000",
    "number": "1295822500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "351 HITCHCOCK WAY",
            "address_2": "# B120",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931054016",
            "telephone_number": "805-685-8400",
            "fax_number": "805-569-2121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "351 HITCHCOCK WAY",
            "address_2": "B120",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931054016",
            "telephone_number": "805-685-8400",
            "fax_number": "805-569-2121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "BRADLEY",
        "middle_name": "M",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-06",
        "last_updated": "2017-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC19858",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHIROPRACTIC LICENSE",
            "identifier": "DC19858",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "DC0198580",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Barbara, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.