Individual provider Active NPI

Bruce Martin Haberman, D.C.

  • Chiropractor
  • Wellington, FL
National Provider Identifier
1679778724
Registry record updated Sep 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH2367 Issued in FL
Practice address
1501 Menorca CT
Wellington, FL 33414-1050
Phone
(561) 795-2010
Fax
(561) 795-2010
NPI assigned
Jun 19, 2007
Last updated
Sep 9, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 9, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH2367 FL Primary
Chiropractor 111N00000X DC11444 CA

Addresses

Primary practice location

1501 Menorca CT
Wellington, FL 33414-1050

Mailing address

1501 Menorca CT
Wellington, FL 33414-1050
Phone (561) 795-2010

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240815004031 FL Practitioner - Chiropractic 9931647393

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC11444CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Prowellness Plus Inc Chiropractor CurrentSince Jul 21, 2024 Accepting new patients
Prowellness, LLC Current Accepting new patients

Locations

1035 S State Road 7
Ste 311
Wellington, FL 33414
Phone (561) 281-1879

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": "1182211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1252454400000",
    "number": "1679778724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 MENORCA CT",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334141050",
            "telephone_number": "561-795-2010",
            "fax_number": "561-795-2010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 MENORCA CT",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334141050",
            "telephone_number": "561-795-2010",
            "fax_number": "561-795-2010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HABERMAN",
        "first_name": "BRUCE",
        "middle_name": "MARTIN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-19",
        "last_updated": "2009-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH2367",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC11444",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wellington, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.