Active NPI
Christopher Cole Bradburn, D.C.
- Chiropractor
- Knightdale, NC
National Provider Identifier
1649336736
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 3801
- Practice address
- 4025 Village Park Dr
Knightdale, NC 27545-7044 - Phone
- (919) 261-0202
- NPI assigned
- Dec 31, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 038010845 | IL | |
| Chiropractor | 111N00000X | 3801 | NC | Primary |
Addresses
Primary practice location
4025 Village Park Dr
Knightdale, NC 27545-7044
Mailing address
4025 Village Park Dr
Knightdale, NC 27545-7044
Phone (919) 261-0202
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 038010845 | Other | IL | STATE LICENSE# |
| 3801 | Other | NC | NC LICENSE |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 038010845 | IL | MD | Chiropractor |
| 3801 | NC | MD | General Practice Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Trinity Chiropractic Wellness, PLLC | Chiropractor | Past | Accepting new patients |
| Midwest Chiropractic Clinic of Pittsfield, LTD | Chiropractor | Past | Accepting new patients |
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.
-
- Chiropractor
- Knightdale, NC
- NPI 1013186493
-
- Chiropractor
- Pittsfield, IL
- NPI 1477690865
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167523200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1443052800000",
"number": "1649336736",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4025 VILLAGE PARK DR",
"city": "KNIGHTDALE",
"state": "NC",
"postal_code": "275457044",
"telephone_number": "919-261-0202"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4025 VILLAGE PARK DR",
"city": "KNIGHTDALE",
"state": "NC",
"postal_code": "275457044",
"telephone_number": "919-261-0202"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRADBURN",
"first_name": "CHRISTOPHER",
"middle_name": "COLE",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-31",
"last_updated": "2015-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "IL",
"license": "038010845",
"primary": false
},
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "NC",
"license": "3801",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE#",
"identifier": "038010845",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NC LICENSE",
"identifier": "3801",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Knightdale, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.