Organization Active NPI

Brightman Family Tree Chiropractic LLC

  • Chiropractor
  • Bryan, OH
National Provider Identifier
1396895058
Registry record updated Mar 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
BRIGHTMAN FAMILY TREE CHIROPRACTIC LLC
Practice address
05539 State Route 15
Bryan, OH 43506-8874
Phone
(419) 636-3133
Fax
(419) 636-3188
NPI assigned
Jan 12, 2007
Last updated
Mar 27, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2014

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

Authorized official

Name
Anjenette M Brightman, D.C.NPI 1902955602
Title
Vice President
Phone
(419) 636-3133

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X OH Primary

Addresses

Primary practice location

05539 State Route 15
Bryan, OH 43506-8874

Mailing address

05539 State Route 15
PO Box 566
Bryan, OH 43506-8874
Phone (419) 636-3133

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070312000036 OH Part B Supplier - Clinic/Group Practice 2264535392 Receives reassigned benefits from 2 practitioners
Practice locations: Bryan, OH

National Provider Directory

National Provider Directory

Locations

05539 State Route 15
Bryan, OH 43506
Phone (419) 636-3133

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395878400000",
    "number": "1396895058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "05539 STATE ROUTE 15",
            "address_2": "PO BOX 566",
            "city": "BRYAN",
            "state": "OH",
            "postal_code": "435068874",
            "telephone_number": "419-636-3133",
            "fax_number": "419-636-3188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "05539 STATE ROUTE 15",
            "city": "BRYAN",
            "state": "OH",
            "postal_code": "435068874",
            "telephone_number": "419-636-3133",
            "fax_number": "419-636-3188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIGHTMAN FAMILY TREE CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-12",
        "last_updated": "2014-03-27",
        "status": "A",
        "authorized_official_last_name": "BRIGHTMAN",
        "authorized_official_first_name": "ANJENETTE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "419-636-3133",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryan, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.