Active NPI
Brent James Derocher, DC
- Chiropractor
- Norwalk, IA
National Provider Identifier
1336381920
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 007170
- Practice address
- 1128 Sunset Dr
Norwalk, IA 50211-1340 - Phone
- (515) 981-0036
- NPI assigned
- Mar 30, 2009
- 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 | 007170 | IA | Primary |
Addresses
Primary practice location
1128 Sunset Dr
Norwalk, IA 50211-1340
Mailing address
1128 Sunset Dr
Norwalk, IA 50211-1340
Phone (515) 981-0036
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090515000369 | IA | Practitioner - Chiropractic | 9739238049 | Practice locations: Norwalk, IA |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Palmer College Chiropractic - Davenport, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1128 Sunset Dr
Norwalk, IA 50211-1340
Phone (515) 981-0036
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 007170 | IA | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| GRX Holdings LLC | Past | Accepting new patients |
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.
-
- Community/Retail Pharmacy
- Norwalk, IA
- NPI 1124086533
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1238371200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1412035200000",
"number": "1336381920",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1128 SUNSET DR",
"city": "NORWALK",
"state": "IA",
"postal_code": "502111340",
"telephone_number": "515-981-0036"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1128 SUNSET DR",
"city": "NORWALK",
"state": "IA",
"postal_code": "502111340",
"telephone_number": "515-981-0036"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEROCHER",
"first_name": "BRENT",
"middle_name": "JAMES",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-03-30",
"last_updated": "2014-09-30",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "IA",
"license": "007170",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Norwalk, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2014; 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.