Bryan R Gerondale, D.C.

Primary specialty

Sports Physician ChiropractorTaxonomy code 111NS0005X

License

1776-012 Issued in WI

Practice address

5306 N Port Washington Rd
Glendale, WI 53217-4913

Phone

(414) 332-0859

Fax

(414) 332-3991

NPI assigned

Oct 6, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Chiropractic Company - Grafton LLP

  • Chiropractor
  • Grafton, WI
  • NPI 1417081159
  NPD (past)
• Chiropractic Company - Greenfield II LTD

  • Chiropractor
  • Greenfield, WI
  • NPI 1366502734
  NPD (past)
• Chiropractic Company - Hartland LTD

  • Chiropractor
  • Hartland, WI
  • NPI 1407474869
  NPD (past)
• Chiropractic Company - Milwaukee East LTD.

  • Chiropractor
  • Milwaukee, WI
  • NPI 1790080984
  NPD (past)
• Chiropractic Company - Shorewood

  • Chiropractor
  • Shorewood, WI
  • NPI 1841595030
  NPD (past)
• Chiropractic Company - Third Ward LTD

  • Chiropractor
  • Milwaukee, WI
  • NPI 1952647802
  NPD (past)
• Chiropractic Company - West Allis East LTD

  • Chiropractor
  • West Allis, WI
  • NPI 1376017517
  NPD (past)
• Chiropractic Company - West Allis LTD

  • Chiropractor
  • West Allis, WI
  • NPI 1528122611
  NPD (past)

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491264000000",
    "number": "1598852147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5306 N PORT WASHINGTON RD",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532174913",
            "telephone_number": "414-332-0859",
            "fax_number": "414-332-3991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5306 N PORT WASHINGTON RD",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532174913",
            "telephone_number": "414-332-0859",
            "fax_number": "414-332-3991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERONDALE",
        "first_name": "BRYAN",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-06",
        "last_updated": "2017-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "WI",
            "license": "1776-012",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "1776-12",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38776000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Olalekan Lukman Ganiyu, PT, MHSC, MTC
• Gateway Personal Care Agency LLC.
• Ge Butterfield MDSC
• Rebecca Gehin, OTR
• Gentle Touch Nurturing Service
• Gretchen J. Gill, PH.D.
• Michael H Gilman, D.O.
• Alyssa Gilster, APSW
• Gaelyn R Gingery
• Glen Haven Counseling Clinic

• Sports Physician Chiropractor in Glendale, WI
• Providers in Glendale, WI by specialty
• Sports Physician Chiropractor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2017; 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.