Brosmer Chiropractic, Inc.
Organization Active NPI Chiropractor · Jasper, IN
NPI 1295914927 · NPPES record last updated Apr 11, 2008
Key facts
- NPI
- 1295914927
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- License
- 08001991A (IN)
- Legal business name
- BROSMER CHIROPRACTIC, INC.
- Practice address
- 1525 Newton St
Jasper, IN 47546-1622 - Phone
- (812) 634-1977
- NPI assigned
- Oct 30, 2007
- Organization subpart
- No
Authorized official
- Name
- Dr. Jared Michael Brosmer, D.C.
- Title
- President
- Phone
- (812) 634-1977
Practitioners 1
-
Jared Michael Brosmer, D.C.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20111108000580 | IN | Part B Supplier - Clinic/Group Practice | 1951574946 |
Receives reassigned benefits from 1 practitioner Practice locations: Jasper, IN |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | 08001991A | IN | Yes |
Addresses
Primary practice location
1525 Newton St
Jasper, IN 47546-1622
Mailing address
1525 Newton St
Jasper, IN 47546-1622
Phone (812) 634-1977
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000202113 | Other | IN | ANTHEM |
Other providers in Jasper, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 11, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.