Individual provider Active NPI

Bradley Duane Lokken, D.C.

  • Chiropractor
  • Flint, MI
National Provider Identifier
1386715530
Registry record updated Sep 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301004278 Issued in MI
Practice address
1125 Villa Linde CT
Suite # 40
Flint, MI 48532-3410
Phone
(810) 720-2225
NPI assigned
Nov 10, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 27, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2301004278 MI Primary

Addresses

Primary practice location

1125 Villa Linde CT
Suite # 40
Flint, MI 48532-3410

Mailing address

1125 Villa Linde CT
Suite # 40
Flint, MI 48532-3410
Phone (810) 720-2225

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111129000774 MI Practitioner - Chiropractic 1254505316 Practice locations: Flint, MI

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Sherman College of Straight Chiropractic, 1980
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1125 Villa Linde CT
Flint, MI 48532-3410
Phone (810) 720-2225

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2301004278MIMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1163116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317081600000",
    "number": "1386715530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 VILLA LINDE CT",
            "address_2": "SUITE # 40",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485323410",
            "telephone_number": "810-720-2225",
            "fax_number": "810-720-1440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 VILLA LINDE CT",
            "address_2": "SUITE # 40",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485323410",
            "telephone_number": "810-720-2225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOKKEN",
        "first_name": "BRADLEY",
        "middle_name": "DUANE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-10",
        "last_updated": "2011-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301004278",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flint, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2011; 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.