Organization Active NPI

Creek Chiropractic LLC

  • Chiropractor
  • Beavercreek, OH
National Provider Identifier
1619604691
Registry record updated Aug 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
CREEK CHIROPRACTIC LLC
Practice address
1911 N Fairfield Rd Ste 230
Beavercreek, OH 45432-2754
Phone
(937) 789-7341
NPI assigned
Aug 1, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2022

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

Authorized official

Name
Brain Briggs, DC
Title
Owner
Phone
(937) 789-7341

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

1911 N Fairfield Rd Ste 230
Beavercreek, OH 45432-2754

Mailing address

1911 N Fairfield Rd Ste 230
Beavercreek, OH 45432-2754
Phone (937) 789-7341

Other identifiers 1

IdentifierTypeStateIssuer
0372884MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220831002014 OH Part B Supplier - Clinic/Group Practice 8527442136 Receives reassigned benefits from 1 practitioner
Practice locations: Beavercreek, OH

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1659312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660262400000",
    "number": "1619604691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1911 N FAIRFIELD RD STE 230",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454322754",
            "telephone_number": "937-789-7341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1911 N FAIRFIELD RD STE 230",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454322754",
            "telephone_number": "937-789-7341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREEK CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-01",
        "last_updated": "2022-08-12",
        "certification_date": "2022-08-12",
        "status": "A",
        "authorized_official_last_name": "BRIGGS",
        "authorized_official_first_name": "BRAIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "937-789-7341",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0372884",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beavercreek, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2022; 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.