Individual provider Active NPI

Bradley Earl Greenwell, D.C.

  • Chiropractor
  • Bowling Green, KY
National Provider Identifier
1477982304
Registry record updated Nov 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5413 Issued in KY
Practice address
720 State St
Bowling Green, KY 42101-2247
Phone
(270) 843-2255
Fax
(270) 782-2822
NPI assigned
Nov 1, 2013
Last updated
Nov 1, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5413 KY Primary

Addresses

Primary practice location

720 State St
Bowling Green, KY 42101-2247

Mailing address

720 State St
Bowling Green, KY 42101-2247
Phone (270) 843-2255

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150204001507 KY Practitioner - Chiropractic 6608190574 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Downtown Chiropractic LLCGroup PAC ID 2163746033, 3 clinicians

Practice addresses (Care Compare)

1548 US 31W Byp
Suite 2
Bowling Green, KY 42101-3015
Phone (270) 843-2255

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5413KYMDSocial Worker

Organizations & group practices 1

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": "1383264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383264000000",
    "number": "1477982304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 STATE ST",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421012247",
            "telephone_number": "270-843-2255",
            "fax_number": "270-782-2822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 STATE ST",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421012247",
            "telephone_number": "270-843-2255",
            "fax_number": "270-782-2822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENWELL",
        "first_name": "BRADLEY",
        "middle_name": "EARL",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-11-01",
        "last_updated": "2013-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "KY",
            "license": "5413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowling Green, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2013; 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.