Jacob Blake Brumbelow

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

264594 Issued in KY

Practice address

520 N State Road 135 Ste R
Greenwood, IN 46142-1321

Phone

(317) 893-3853

NPI assigned

Jan 20, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Greenwood Family Chiropractic, LLC

  • Chiropractor
  • Greenwood, IN
  • NPI 1164708202
  NPD

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

{
    "created_epoch": "1579478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628640000000",
    "number": "1396375242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10306 SHELBYVILLE RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402232914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 N STATE ROAD 135 STE R",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461421321",
            "telephone_number": "317-893-3853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUMBELOW",
        "first_name": "JACOB",
        "middle_name": "BLAKE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-01-20",
        "last_updated": "2021-08-11",
        "certification_date": "2021-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "KY",
            "license": "264594",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "08003139A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.vericle.com",
            "affiliation": "N",
            "endpointDescription": "EHR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "520 N. SR 135",
            "address_2": "Suite R",
            "city": "Greenwood",
            "state": "IN",
            "country_code": "US",
            "postal_code": "46142",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Rebecca Brown
• Stewart C Brown, MD
• Christopher J Browning, OD
• Cherie Bruckman, L.S.W.
• Elizabeth Bruhl
• Emily Brumfield, NP
• Glen A. Brunk, M.D.
• Aaron Scott Bruns, M.D.
• Andrianna Bryars, RBT
• Brynexa Medical Billing LLC

• Chiropractor in Greenwood, IN
• Providers in Greenwood, IN by specialty
• Chiropractor in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.