Individual provider Active NPI

Brian David Bauer, D.O

  • Rehabilitation Chiropractor
  • Plantation, FL
National Provider Identifier
1487877528
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation ChiropractorTaxonomy code 111NR0400X
License
7924 Issued in FL
Practice address
10017 Cleary Blvd
Plantation, FL 33324-1000
Phone
(954) 916-1133
Fax
(954) 916-0096
NPI assigned
Apr 10, 2007
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
Rehabilitation Chiropractor 111NR0400X 7924 FL Primary

Addresses

Primary practice location

10017 Cleary Blvd
Plantation, FL 33324-1000

Mailing address

PO Box 741235
Boynton Beach, FL 33474-1235
Phone (954) 941-2679

Other identifiers 1

IdentifierTypeStateIssuer
7924OtherFLLISCENSE NUMBER

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
7924FLMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Complete Rehab & Medical Center of Plantation Rehabilitation Past Accepting new patients
Complete Rehab & Medical Center of West Palm Beach Rehabilitation Past Accepting new patients

Organizations & group practices 2

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": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487877528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 741235",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334741235",
            "telephone_number": "954-941-2679",
            "fax_number": "954-941-6169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10017 CLEARY BLVD",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333241000",
            "telephone_number": "954-916-1133",
            "fax_number": "954-916-0096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUER",
        "first_name": "BRIAN",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "D.O",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "FL",
            "license": "7924",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LISCENSE NUMBER",
            "identifier": "7924",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plantation, FL

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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.