Individual provider Active NPI

Bryan Carl Osborne, DC

  • Chiropractor
  • Raleigh, NC
National Provider Identifier
1518985803
Registry record updated Dec 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2871 Issued in NC
Practice address
5603 Duraleigh Rd Ste 101
Raleigh, NC 27612-2688
Phone
(919) 571-7311
Fax
(919) 783-7835
NPI assigned
Jul 17, 2006
Last updated
Dec 21, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 21, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2871 NC Primary

Addresses

Primary practice location

5603 Duraleigh Rd Ste 101
Raleigh, NC 27612-2688

Mailing address

5603 Duraleigh Rd Ste 101
Raleigh, NC 27612-2688
Phone (919) 571-7311

Other identifiers 3

IdentifierTypeStateIssuer
085CROtherBLUE CROSS/BLUE SHIELD
89085MedicaidNC
562267692OtherACN AND HUMANA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080410000242 NC Practitioner - Chiropractic 7113004441

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5603 Duraleigh Rd
Suite 101
Raleigh, NC 27612-2688

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2871NCMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Osborne Chiropractic Clinic LL PA Chiropractor Current 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, 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": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261353600000",
    "number": "1518985803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5603 DURALEIGH RD STE 101",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276122688",
            "telephone_number": "919-571-7311",
            "fax_number": "919-783-7835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5603 DURALEIGH RD STE 101",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276122688",
            "telephone_number": "919-571-7311",
            "fax_number": "919-783-7835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSBORNE",
        "first_name": "BRYAN",
        "middle_name": "CARL",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2009-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "2871",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "085CR",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89085",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACN  AND HUMANA",
            "identifier": "562267692",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2009; 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.