Individual provider Active NPI

Nate Bradley Bubak, DC

  • Chiropractor
  • Rogers, AR
National Provider Identifier
1639815509
Registry record updated Jun 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
16343 Issued in AR
Practice address
5505 W Walsh LN Ste 100
Rogers, AR 72758-8941
Phone
(479) 715-6772
NPI assigned
May 12, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 16343 AR Primary

Addresses

Primary practice location

5505 W Walsh LN Ste 100
Rogers, AR 72758-8941

Mailing address

695 N Razorback Rd
Fayetteville, AR 72701-3056

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
16343ARMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Chiropractic & Family Wellness Chiropractor CurrentSince May 16, 2022 Accepting new patients
PCFW Acquisition, LLC Chiropractor CurrentSince Jul 24, 2022 Accepting new patients

Locations

5505 W Walsh Ln
#100
Rogers, AR 72758
Phone (479) 715-6772

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": "1652313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654473600000",
    "number": "1639815509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "695 N RAZORBACK RD",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727013056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5505 W WALSH LN STE 100",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727588941",
            "telephone_number": "479-715-6772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUBAK",
        "first_name": "NATE",
        "middle_name": "BRADLEY",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-12",
        "last_updated": "2022-06-06",
        "certification_date": "2022-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AR",
            "license": "16343",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rogers, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2022; 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.