Individual provider Active NPI

Brock Pluth, DC

  • Chiropractor
  • Naperville, IL
National Provider Identifier
1477123669
Registry record updated Jun 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038013706 Issued in IL
Practice address
1415 Bond St Ste 171
Naperville, IL 60563-2769
Phone
(331) 204-6196
NPI assigned
Jun 29, 2021
Last updated
Jun 29, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038013706 IL Primary

Addresses

Primary practice location

1415 Bond St Ste 171
Naperville, IL 60563-2769

Mailing address

1415 Bond St Ste 171
Naperville, IL 60563-2769

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220112000718 IL Practitioner - Chiropractic 1052703618 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Martin J Labuda DC PCGroup PAC ID 6305095043, 2 clinicians

Practice addresses (Care Compare)

3832 N Broadway St
Chicago, IL 60613-3218
Phone (773) 296-2225

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Phoenix Chiropractic LLC CurrentSince Jul 4, 2021 Accepting new patients
Dr. Jess Enderby LLC Chiropractor CurrentSince Jul 4, 2021 Accepting new patients
Martin J. Labuda, DC, PC Chiropractor CurrentSince Dec 6, 2021 Accepting new patients

Locations

3832 N Broadway St
Chicago, IL 60613
Phone (773) 296-2225

1415 Bond St
Ste 171
Naperville, IL 60563
Phone (331) 204-6196

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1624924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624924800000",
    "number": "1477123669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1415 BOND ST STE 171",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605632769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 BOND ST STE 171",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605632769",
            "telephone_number": "331-204-6196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLUTH",
        "first_name": "BROCK",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-29",
        "last_updated": "2021-06-29",
        "certification_date": "2021-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038013706",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2021; 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.

Verify at the official NPI Registry.