Organization Active NPI

Brown Spine & Sportschiropractic Clinic, PLLC

  • Chiropractor
  • Fort Worth, TX
National Provider Identifier
1558653535
Registry record updated May 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
10586 Issued in TX
Legal business name
BROWN SPINE & SPORTSCHIROPRACTIC CLINIC, PLLC
Practice address
6040 Camp Bowie Blvd
Ste 2
Fort Worth, TX 76116-5612
Phone
(817) 763-8301
Fax
(817) 764-6488
NPI assigned
May 9, 2011
Last updated
May 9, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 9, 2011

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

Authorized official

Name
Dr. Daniel Lee Brown, D.C.NPI 1356574545
Title
Owner/Chiropractor
Phone
(817) 763-8301

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 10586 TX Primary

Addresses

Primary practice location

6040 Camp Bowie Blvd
Ste 2
Fort Worth, TX 76116-5612

Mailing address

6040 Camp Bowie Blvd
Ste 2
Fort Worth, TX 76116-5612
Phone (817) 763-8301

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110906000468 TX Part B Supplier - Clinic/Group Practice 1153591961 Receives reassigned benefits from 1 practitioner
Practice locations: Fort Worth, TX

National Provider Directory

National Provider Directory
Tax ID family
Brown Spine Sports Chiropractic Clinic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1304899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1304899200000",
    "number": "1558653535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6040 CAMP BOWIE BLVD",
            "address_2": "STE 2",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761165612",
            "telephone_number": "817-763-8301",
            "fax_number": "817-764-6488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6040 CAMP BOWIE BLVD",
            "address_2": "STE 2",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761165612",
            "telephone_number": "817-763-8301",
            "fax_number": "817-764-6488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROWN SPINE & SPORTSCHIROPRACTIC CLINIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-09",
        "last_updated": "2011-05-09",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OWNER/CHIROPRACTOR",
        "authorized_official_telephone_number": "817-763-8301",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "10586",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.