Active NPI
Brooke Nichole Frye, D.C.
- Chiropractor
- Glen Carbon, IL
National Provider Identifier
1386780773
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 038.010829
- Practice address
- 3809 S. State Route 159
Glen Carbon, IL 62034-3020 - Phone
- (618) 692-1800
- Fax
- (618) 205-8664
- NPI assigned
- Jan 30, 2007
- Sex
- Female
- Sole proprietor
- No
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 | 038.010829 | IL | Primary |
Addresses
Primary practice location
3809 S. State Route 159
Glen Carbon, IL 62034-3020
Mailing address
3809 S State Route 159
Glen Carbon, IL 62034-3020
Phone (618) 692-1800
Other names 1
- Dr. Brooke Nichole Lawson
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090225000686 | IL | Practitioner - Chiropractic | 2365538428 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Logan College of Chiropractic, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3809 S State Route 159
Glen Carbon, IL 62034-3020
Phone (618) 692-1800
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 038.010829 | IL | MD | Chiropractor |
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": "1170115200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1722902400000",
"number": "1386780773",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3809 S STATE ROUTE 159",
"city": "GLEN CARBON",
"state": "IL",
"postal_code": "620343020",
"telephone_number": "618-692-1800",
"fax_number": "618-205-8664"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3809 S. STATE ROUTE 159",
"city": "GLEN CARBON",
"state": "IL",
"postal_code": "620343020",
"telephone_number": "618-692-1800",
"fax_number": "618-205-8664"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FRYE",
"first_name": "BROOKE",
"middle_name": "NICHOLE",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-30",
"last_updated": "2024-08-06",
"certification_date": "2024-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "IL",
"license": "038.010829",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "BROOKE",
"last_name": "LAWSON",
"middle_name": "NICHOLE",
"prefix": "DR.",
"credential": "D.C.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Glen Carbon, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2024; 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.