Individual provider Active NPI

Bradley Forbes, DC

  • Chiropractor
  • Phoenix, AZ
National Provider Identifier
1487680708
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
7705 Issued in AZ
Practice address
40 N Central Ave Ste 775
Phoenix, AZ 85004-4413
Phone
(602) 889-5833
Fax
(602) 889-5834
NPI assigned
Jun 26, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 7705 AZ Primary

Addresses

Primary practice location

40 N Central Ave Ste 775
Phoenix, AZ 85004-4413

Mailing address

40 N Central Ave Ste 775
Phoenix, AZ 85004-4413
Phone (602) 889-5833

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160205002294 AZ Practitioner - Chiropractic 4486958758 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fiesta Health Services LLCGroup PAC ID 5294031068, 5 clinicians

Practice addresses (Care Compare)

1234 S Power Rd
Suite 202
Mesa, AZ 85206-3763
Phone (480) 649-5297

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Fiesta Health Services LLC Chiropractor CurrentSince Jan 28, 2014 Accepting new patients

Locations

1303 S Longmore
Ste 8
Mesa, AZ 85202
Phone (480) 649-5297

1234 S Power Rd
Ste 202
Mesa, AZ 85206
Phone (480) 649-5297

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487680708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 N CENTRAL AVE STE 775",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850044413",
            "telephone_number": "602-889-5833",
            "fax_number": "602-889-5834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 N CENTRAL AVE STE 775",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850044413",
            "telephone_number": "602-889-5833",
            "fax_number": "602-889-5834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORBES",
        "first_name": "BRADLEY",
        "name_prefix": "Mr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "7705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.