Individual provider Active NPI

Bradley David Johnson, D.C.

  • Chiropractor
  • Oxford, NC
National Provider Identifier
1669580205
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3075 Issued in NC
Practice address
304 Hillsboro St Ste D
Oxford, NC 27565-3274
Phone
(919) 693-3577
Fax
(919) 693-3582
NPI assigned
Aug 25, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3075 NC Primary

Addresses

Primary practice location

304 Hillsboro St Ste D
Oxford, NC 27565-3274

Mailing address

304 Hillsboro St Ste D
Oxford, NC 27565-3274
Phone (919) 693-3577

Other identifiers 3

IdentifierTypeStateIssuer
085HJOtherNCBLUE CROSS/BLUE SHIELD
P00160884OtherNCRAILROAD MEDICARE PROGRAM
89085HJMedicaidNC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041029000244 NC Practitioner - Chiropractic 3476515784 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

820 S Garnett St
Henderson, NC 27536-4513
Phone (252) 431-1700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Dorrance Chiropractic Center Inc Chiropractor CurrentSince Jan 25, 2010 Accepting new patients
Aes Medical PC CurrentSince Nov 25, 2022 Accepting new patients
Oxford Accident and Injury Center, Inc. Chiropractor PastSince Sep 27, 2004 Accepting new patients

Locations

820 S Garnett St
Henderson, NC 27536
Phone (252) 431-1700

Organizations & group practices 3

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": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669580205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 HILLSBORO ST STE D",
            "city": "OXFORD",
            "state": "NC",
            "postal_code": "275653274",
            "telephone_number": "919-693-3577",
            "fax_number": "919-693-3582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 HILLSBORO ST STE D",
            "city": "OXFORD",
            "state": "NC",
            "postal_code": "275653274",
            "telephone_number": "919-693-3577",
            "fax_number": "919-693-3582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "BRADLEY",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "3075",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "085HJ",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PROGRAM",
            "identifier": "P00160884",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89085HJ",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oxford, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.