Active NPI
Brent Douglas Froberg, DC
- Rehabilitation Chiropractor
- Tacoma, WA
National Provider Identifier
1659894020
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Chiropractor
- License
- CH60766830
- Practice address
- 2079 Mildred St W FL 6
Tacoma, WA 98466-6133 - Phone
- (800) 404-6050
- Fax
- (866) 313-3397
- NPI assigned
- Jul 18, 2017
- Last updated
- Dec 13, 2022
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rehabilitation Chiropractor | 111NR0400X | CH60766830 | WA | Primary |
Addresses
Primary practice location
2079 Mildred St W FL 6
Tacoma, WA 98466-6133
Mailing address
PO Box 700688
San Antonio, TX 78270-0688
Phone (210) 318-3007
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CH60766830 | Other | WA | CHIROPRACTIC LICENSE |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | records@airrosti-rehab-ctrs.direct.kno2fy.com | Airrosti Rehab Centers, LLC |
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 |
|---|---|---|---|
| CH60766830 | WA | MD | Rehabilitation Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Free to Move - Rehab & Performance, LLC | Rehabilitation | Current | Accepting new patients |
Organizations & group practices 1
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.
-
- Rehabilitation Chiropractor
- American Fork, UT
- NPI 1942013388
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1500336000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1670889600000",
"number": "1659894020",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 700688",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782700688",
"telephone_number": "210-318-3007",
"fax_number": "210-468-0682"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2079 MILDRED ST W FL 6",
"city": "TACOMA",
"state": "WA",
"postal_code": "984666133",
"telephone_number": "800-404-6050",
"fax_number": "866-313-3397"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FROBERG",
"first_name": "BRENT",
"middle_name": "DOUGLAS",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-07-18",
"last_updated": "2022-12-13",
"certification_date": "2022-12-13",
"status": "A"
},
"taxonomies": [
{
"code": "111NR0400X",
"taxonomy_group": "",
"desc": "Chiropractor, Rehabilitation",
"state": "WA",
"license": "CH60766830",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CHIROPRACTIC LICENSE",
"identifier": "CH60766830",
"state": "WA"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "records@airrosti-rehab-ctrs.direct.kno2fy.com",
"affiliation": "Y",
"affiliationName": "Airrosti Rehab Centers, LLC",
"address_1": "111 Tower Dr Bldg 1",
"city": "San Antonio",
"state": "TX",
"country_code": "US",
"postal_code": "782323625",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Tacoma, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 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.