Active NPI
Bradley M Johnson, D.C.
- Chiropractor
- Santa Barbara, CA
National Provider Identifier
1295822500
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- DC19858
- 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
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 | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DC19858 | Other | CHIROPRACTIC LICENSE | |
| DC0198580 | Other | CA | BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040128001182 | CA | Practitioner - Chiropractic | 6507769403 | Practice locations: Santa Barbara, CA |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DC19858 | CA | MD | Chiropractor |
| 19858 | CA | MD | Periodontist |
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.