Individual provider Active NPI

Brian E Coyle, D.C., F.A.S.B.E.

  • Chiropractor
  • San Jose, CA
National Provider Identifier
1417029612
Registry record updated Sep 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC151690 Issued in CA
Practice address
1711 Branham LN Ste A10
San Jose, CA 95118-5227
Phone
(408) 264-6644
Fax
(408) 264-3515
NPI assigned
Nov 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC151690 CA Primary

Addresses

Primary practice location

1711 Branham LN Ste A10
San Jose, CA 95118-5227

Mailing address

591 W. Hamilton Ave. #160
Cambpell, CA 95008-0521
Phone (408) 264-6644

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Los Angeles College of Chiropractic, 1982
Medicare assignment
May accept Medicare assignment
Group practices
Coyle Chiropractic CorpGroup PAC ID 8426152695, 5 clinicians

Practice addresses (Care Compare)

6110 Hellyer Ave
Suite 100
San Jose, CA 95138-1061
Phone (370) 288-6453

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC151690CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced DME LLC CurrentSince Apr 23, 2024 Accepting new patients
Advanced Medical Center Inc Chiropractor Past Accepting new patients

Locations

3315 Almaden Expy
Ste 20
San Jose, CA 95118
Phone (408) 264-6644

6110 Hellyer Ave
Ste 100
San Jose, CA 95138
Phone (408) 264-6644

Organizations & group practices 3

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": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283299200000",
    "number": "1417029612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "591 W. HAMILTON AVE. #160",
            "city": "CAMBPELL",
            "state": "CA",
            "postal_code": "950080521",
            "telephone_number": "408-264-6644",
            "fax_number": "408-264-3515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1711 BRANHAM LN STE A10",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951185227",
            "telephone_number": "408-264-6644",
            "fax_number": "408-264-3515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COYLE",
        "first_name": "BRIAN",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "D.C., F.A.S.B.E.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-14",
        "last_updated": "2010-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC151690",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.