Individual provider Active NPI

Brandon Beckerman, D.C.

  • Chiropractor
  • Overland Park, KS
National Provider Identifier
1588035836
Registry record updated Oct 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
01-05747 Issued in KS
Practice address
5600 W 95TH St
Suite 201
Overland Park, KS 66207-2921
Phone
(620) 921-0979
NPI assigned
Oct 13, 2015
Last updated
Oct 13, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 01-05747 KS Primary

Addresses

Primary practice location

5600 W 95TH St
Suite 201
Overland Park, KS 66207-2921

Mailing address

9340 Riggs St
Overland Park, KS 66212-1441
Phone (620) 921-0979

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211019002803 TX Practitioner - Chiropractic 0042608390 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
01-05747KSMDChiropractor
14835TXMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Parker University Chiropractor CurrentSince Dec 2, 2021 Accepting new patients
Myocore, LLC Chiropractor PastSince Oct 10, 2021 Accepting new patients

Locations

2600 Electronic Ln
Dallas, TX 75220
Phone (972) 438-6932

2540 Walnut Hill Ln
Dallas, TX 75229
Phone (214) 902-3447

111 S Delaware St
Irving, TX 75060
Phone (214) 438-9355

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/23964/brand/1/csg/1/fhir/r4

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": "1444694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444694400000",
    "number": "1588035836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9340 RIGGS ST",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662121441",
            "telephone_number": "620-921-0979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5600 W 95TH ST",
            "address_2": "SUITE 201",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662072921",
            "telephone_number": "620-921-0979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BECKERMAN",
        "first_name": "BRANDON",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-10-13",
        "last_updated": "2015-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "KS",
            "license": "01-05747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Overland Park, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2015; 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.