Bruce A Brown, D.C.
Individual provider Active NPI Chiropractor · Bellbrook, OH
NPI 1699788869 · NPPES record last updated Jul 15, 2020
Key facts
- NPI
- 1699788869
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- DC-01265 (OH)
- Practice address
- 4299 Sugarcreek Dr
Bellbrook, OH 45305-1330 - Phone
- (937) 848-8500
- Fax
- (937) 848-9500
- NPI assigned
- Aug 15, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- Logan College of Chiropractic, 1986
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
4299 Sugarcreek Dr
Bellbrook, OH 45305-1330
Phone (937) 848-8500
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20051013000007 | OH | Practitioner - Chiropractic | 4082639596 | Practice locations: Bellbrook, OH |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DC-01265 | OH | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Integrative Health and Sports Performance, LLC | Chiropractor | Past |
Accepting new patients |
| Dr. Tyler T Lanning DC LLC | Chiropractor | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | DC-01265 | OH | Yes |
Addresses
Primary practice location
4299 Sugarcreek Dr
Bellbrook, OH 45305-1330
Mailing address
4299 Sugarcreek Dr
Bellbrook, OH 45305-1330
Phone (937) 848-8500
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 75216934200 | Other | OH | BWC |
Other providers in Bellbrook, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 15, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.