Individual provider Active NPI

Barbara Lynn Brake, D.C.

  • Chiropractor
  • Greenville, SC
National Provider Identifier
1568421444
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
0965 Issued in SC
Practice address
4010 E North St
Suite One
Greenville, SC 29615-6207
Phone
(864) 292-2503
Fax
(864) 292-2504
NPI assigned
Mar 21, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

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 0965 SC Primary

Addresses

Primary practice location

4010 E North St
Suite One
Greenville, SC 29615-6207

Mailing address

4010 E North St
Suite One
Greenville, SC 29615-6207
Phone (864) 292-2503

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

State licenses

LicenseStateTypeSpecialty
0965SCMDChiropractor
965SCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Campos Chiropractic LLC Chiropractor CurrentSince Nov 16, 2015 Accepting new patients

Locations

4010 E North St
Ste 1
Greenville, SC 29615
Phone (864) 292-2503

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": "1142899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1568421444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4010 E NORTH ST",
            "address_2": "SUITE ONE",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296156207",
            "telephone_number": "864-292-2503",
            "fax_number": "864-292-2504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4010 E NORTH ST",
            "address_2": "SUITE ONE",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296156207",
            "telephone_number": "864-292-2503",
            "fax_number": "864-292-2504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAKE",
        "first_name": "BARBARA",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "0965",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

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.