Individual provider Active NPI

Michael Brucks, DC

  • Chiropractor
  • Lee's Summit, MO
National Provider Identifier
1679028427
Registry record updated Aug 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2016015738 Issued in MO
Practice address
731 NE Lakewood Blvd
Lees Summit, MO 64064-1353
Phone
(816) 373-3373
NPI assigned
Aug 22, 2016
Last updated
Aug 22, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2016015738 MO Primary

Addresses

Primary practice location

731 NE Lakewood Blvd
Lees Summit, MO 64064-1353

Mailing address

6701 E 134TH Ter
Grandview, MO 64030-3239
Phone (816) 547-9895

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161011002775 MO Practitioner - Chiropractic 1456649276 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Cleveland Chiropractic College - Kansas City, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

895 E Walnut St
Raymore, MO 64083-8100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Heritage Wellness Solutions, LLC Chiropractor CurrentSince Jun 14, 2019 Accepting new patients
Lakewood Chiropractic, P.C. Chiropractor Past Accepting new patients

Locations

103 S Jefferson St
Raymore, MO 64083
Phone (816) 322-1990

895 E Walnut St
Raymore, MO 64083
Phone (816) 322-1990

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": "1471824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471824000000",
    "number": "1679028427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6701 E 134TH TER",
            "city": "GRANDVIEW",
            "state": "MO",
            "postal_code": "640303239",
            "telephone_number": "816-547-9895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "731 NE LAKEWOOD BLVD",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640641353",
            "telephone_number": "816-373-3373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUCKS",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-22",
        "last_updated": "2016-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2016015738",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lee's Summit, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2016; 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.