Individual provider Active NPI

Branden Brana Rivera

  • Chiropractor
  • Charlotte, NC
National Provider Identifier
1558070516
Registry record updated Nov 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5533 Issued in NC
Practice address
6253 South Blvd
Charlotte, NC 28217-4440
Phone
(704) 554-9711
NPI assigned
Nov 18, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5533 NC Primary

Addresses

Primary practice location

6253 South Blvd
Charlotte, NC 28217-4440

Mailing address

504 Eastway Dr
Charlotte, NC 28205-1421

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221205000143 NC Practitioner - Chiropractic 7810366465 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6253 S Blvd
Charlotte, NC 28217-4440
Phone (704) 554-9711

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5533NCMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Demaine Chiropractic &Wellnes Center PA Chiropractor CurrentSince Nov 18, 2022 Accepting new patients

Locations

6253 South Blvd
Charlotte, NC 28217
Phone (704) 554-9711

504 Eastway Dr
Charlotte, NC 28205
Phone (704) 372-6960

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": "1668729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668729600000",
    "number": "1558070516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 EASTWAY DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282051421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6253 SOUTH BLVD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282174440",
            "telephone_number": "704-554-9711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANA RIVERA",
        "first_name": "BRANDEN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-11-18",
        "last_updated": "2022-11-18",
        "certification_date": "2022-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "5533",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2022; 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.