Individual provider Active NPI

Brandon William Bird, D.C.

  • Chiropractor
  • Voorhees, NJ
National Provider Identifier
1376690750
Registry record updated Sep 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
38MC00606300 Issued in NJ
Practice address
1307 White Horse Rd
Building B Suite 200
Voorhees, NJ 08043-2119
Phone
(856) 783-6789
Fax
(856) 783-7199
NPI assigned
Jan 5, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 8, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 38MC00606300 NJ Primary
Chiropractor 111N00000X DC009084 PA

Addresses

Primary practice location

1307 White Horse Rd
Building B Suite 200
Voorhees, NJ 08043-2119

Mailing address

1307 White Horse Rd
Building B Ste 200
Voorhees, NJ 08043-2119
Phone (856) 783-6789

Other identifiers 15

IdentifierTypeStateIssuer
113676280OtherNJHORIZON BCBS
113676280OtherPACARPENTERS HEALTH AND WEL
113676280OtherNJALLSTATE
2212354000OtherPAAMERIHEALTH PPO
665240OtherGAACN
0062766MedicaidNJ
113676280OtherNJATLANTICARE ADMINISTRATOR
113676280OtherNJCONCENTRA
113676280OtherUTDESERET MUTUAL
066247OtherMDAPWU HEALTH PLAN
3020655OtherTXAETNA
665240OtherGAUNITED HEALTH CARE
2212354000OtherPAKEYSTONE HEALTH PLAN EAST
2213023000OtherPAINDEPENDENCE BLUE CROSS
3020655OtherNJAETNA HMO

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050414001114 NJ Practitioner - Chiropractic 7517904121 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1307 White Horse Rd
Suite 200
Voorhees, NJ 08043-2119
Phone (856) 783-6789

7150 N Park Dr
Suite 420
Pennsauken, NJ 08109-4215
Phone (856) 783-6789

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC009084PAMDChiropractor

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": "1167955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599523200000",
    "number": "1376690750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1307 WHITE HORSE RD",
            "address_2": "BUILDING B STE 200",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080432119",
            "telephone_number": "856-783-6789",
            "fax_number": "856-783-7199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1307 WHITE HORSE RD",
            "address_2": "BUILDING B SUITE 200",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080432119",
            "telephone_number": "856-783-6789",
            "fax_number": "856-783-7199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIRD",
        "first_name": "BRANDON",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-05",
        "last_updated": "2020-09-08",
        "certification_date": "2020-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00606300",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC009084",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HORIZON BCBS",
            "identifier": "113676280",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARPENTERS HEALTH AND WEL",
            "identifier": "113676280",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALLSTATE",
            "identifier": "113676280",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH PPO",
            "identifier": "2212354000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACN",
            "identifier": "665240",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0062766",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ATLANTICARE ADMINISTRATOR",
            "identifier": "113676280",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONCENTRA",
            "identifier": "113676280",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DESERET MUTUAL",
            "identifier": "113676280",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APWU HEALTH PLAN",
            "identifier": "066247",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "3020655",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "665240",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE HEALTH PLAN EAST",
            "identifier": "2212354000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENCE BLUE CROSS",
            "identifier": "2213023000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "3020655",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Voorhees, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2020; 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.