Individual provider Active NPI

Brian Michael Edens, D.C.

  • Chiropractor
  • Lakewood Ranch, FL
National Provider Identifier
1619070877
Registry record updated Feb 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH 7915 Issued in FL
Practice address
8430 Enterprise Circle
Suite 120
Lakewood Ranch, FL 34202-5137
Phone
(941) 907-9663
Fax
(941) 907-6663
NPI assigned
Sep 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH 7915 FL Primary

Addresses

Primary practice location

8430 Enterprise Circle
Suite 120
Lakewood Ranch, FL 34202-5137

Mailing address

8430 Enterprise Circle
Suite 120
Lakewood Ranch, FL 34202-5137
Phone (941) 907-9663

Other identifiers 2

IdentifierTypeStateIssuer
002413069OtherFLUNITED HEALTH CARE
55950OtherFLBCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220517000462 TN Practitioner - Chiropractic 9436334851

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH 7915FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Well Health & Chiropractic, Inc. Chiropractor CurrentSince May 3, 2022 Accepting new patients
Good Business LLC Chiropractor PastSince Jul 7, 2000 Accepting new patients

Locations

204 Iris Dr
Hendersonville, TN 37075
Phone (615) 264-9313

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328140800000",
    "number": "1619070877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8430 ENTERPRISE CIRCLE",
            "address_2": "SUITE 120",
            "city": "LAKEWOOD RANCH",
            "state": "FL",
            "postal_code": "342025137",
            "telephone_number": "941-907-9663",
            "fax_number": "941-907-6663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8430 ENTERPRISE CIRCLE",
            "address_2": "SUITE 120",
            "city": "LAKEWOOD RANCH",
            "state": "FL",
            "postal_code": "342025137",
            "telephone_number": "941-907-9663",
            "fax_number": "941-907-6663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDENS",
        "first_name": "BRIAN",
        "middle_name": "MICHAEL",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-06",
        "last_updated": "2012-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH 7915",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "002413069",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "55950",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood Ranch, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2012; 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.