Brad Egbert Chiropractic LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CHIA543 Issued in ID

Legal business name

BRAD EGBERT CHIROPRACTIC LLC

Practice address

1134 Bond Ave
Rexburg, ID 83440-3582

Phone

(208) 356-8818

Fax

(208) 356-0458

NPI assigned

Sep 10, 2008

Last updated

Sep 10, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Brad Egbert, D.C.NPI 1134279565

Title

Owner/Manager

Phone

(208) 356-8818

Specialties & licenses 1

Addresses

Other identifiers 1

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.

• Brad Richard Egbert, D.C.

  • Chiropractor
  • Rexburg, ID
  • NPI 1134279565
  Authorized official Same address or phone

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

{
    "created_epoch": "1221004800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221004800000",
    "number": "1578712949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1134 BOND AVE",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834403582",
            "telephone_number": "208-356-8818",
            "fax_number": "208-356-0458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1134 BOND AVE",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834403582",
            "telephone_number": "208-356-8818",
            "fax_number": "208-356-0458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRAD EGBERT CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-10",
        "last_updated": "2008-09-10",
        "status": "A",
        "authorized_official_last_name": "EGBERT",
        "authorized_official_first_name": "BRAD",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "208-356-8818",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "ID",
            "license": "CHIA543",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PERSONAL NPI NUMBER",
            "identifier": "1134279565",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Boost Ventures PLLC (Boost Physical Therapy)
• David George Booth, D.C.
• Bounce Back OT LLC
• Danielle Bowen, LMT
• Kreed Bowman, O.D.
• Dustin Zachary Brady
• Debra Brand, MD
• Kavin Branham, LCPC
• Brannon & Brannon Psychological Services PA
• James M Brannon, ED.D.

• Chiropractor in Rexburg, ID
• Providers in Rexburg, ID by specialty
• Chiropractor in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2008; 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.