Organization Active NPI

Tybradshaw Chiropractic

  • Chiropractor
  • Gilbert, AZ
National Provider Identifier
1417399981
Registry record updated Jul 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
8338 Issued in AZ
Legal business name
TYBRADSHAW CHIROPRACTIC
Practice address
4179 E Fairbanks St
Gilbert, AZ 85295-6148
Phone
(801) 859-9485
NPI assigned
Jul 24, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2013

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

Authorized official

Name
Tyler Bradshaw, DC
Title
Chiropractor
Phone
(801) 859-9485

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 8338 AZ Primary

Addresses

Primary practice location

4179 E Fairbanks St
Gilbert, AZ 85295-6148

Mailing address

4179 E Fairbanks St
Gilbert, AZ 85295-6148

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1374624000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374624000000",
    "number": "1417399981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4179 E FAIRBANKS ST",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852956148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4179 E FAIRBANKS ST",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852956148",
            "telephone_number": "801-859-9485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TYBRADSHAW CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-24",
        "last_updated": "2013-07-24",
        "status": "A",
        "authorized_official_last_name": "BRADSHAW",
        "authorized_official_first_name": "TYLER",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "801-859-9485",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "8338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2013; 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.