Individual provider Active NPI

John David Brouse, D.C.

  • Chiropractor
  • Ebensburg, PA
National Provider Identifier
1689764797
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC008898 Issued in PA
Practice address
1104 W High St
Unit 4a
Ebensburg, PA 15931-1707
Phone
(814) 472-9355
Fax
(814) 472-0886
NPI assigned
Oct 13, 2006
Sex
Male
Sole proprietor
No

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 DC008898 PA Primary

Addresses

Primary practice location

1104 W High St
Unit 4a
Ebensburg, PA 15931-1707

Mailing address

1104 W High St
Unit 4a
Ebensburg, PA 15931-1707
Phone (814) 472-9355

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040119000269 PA Practitioner - Chiropractic 3173424561 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2002
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

948 W High St
Ebensburg, PA 15931-1806
Phone (814) 472-9355

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC008898PAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Wellness 1St, P.C. Chiropractor CurrentSince Nov 1, 2006 Accepting new patients
Thomas R. Brouse III, D.C. P.C. Chiropractor PastSince Mar 15, 2002 Accepting new patients

Locations

948 W High St
Ebensburg, PA 15931
Phone (814) 472-9355

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689764797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1104 W HIGH ST",
            "address_2": "UNIT 4A",
            "city": "EBENSBURG",
            "state": "PA",
            "postal_code": "159311707",
            "telephone_number": "814-472-9355",
            "fax_number": "814-472-0886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1104 W HIGH ST",
            "address_2": "UNIT 4A",
            "city": "EBENSBURG",
            "state": "PA",
            "postal_code": "159311707",
            "telephone_number": "814-472-9355",
            "fax_number": "814-472-0886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROUSE",
        "first_name": "JOHN",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC008898",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ebensburg, PA

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.