Loren S Brunner, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

X009649 Issued in NY

Practice address

510 Oliver St
North Tonawanda, NY 14120-4300

Phone

(716) 693-5646

Fax

(716) 693-2667

NPI assigned

Apr 23, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Specialty

Chiropractic

Education

New York Chiropractic College, 1999

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Twin City Chiropractic

  • Chiropractor
  • North Tonawanda, NY
  • NPI 1376742288
  NPD Authorized official
• Thorne Chiropractic Office, PC

  • Chiropractor
  • North Tonawanda, NY
  • NPI 1902093628
  NPD (past)

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417824000000",
    "number": "1710105036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 OLIVER ST",
            "city": "NORTH TONAWANDA",
            "state": "NY",
            "postal_code": "141204300",
            "telephone_number": "716-693-5646",
            "fax_number": "716-693-2667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 OLIVER ST",
            "city": "NORTH TONAWANDA",
            "state": "NY",
            "postal_code": "141204300",
            "telephone_number": "716-693-5646",
            "fax_number": "716-693-2667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNNER",
        "first_name": "LOREN",
        "middle_name": "S",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-23",
        "last_updated": "2014-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X009649",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "1710105036",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TWIN CITY CHIROPRACTIC",
            "identifier": "J100057652",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "X009649-1",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "16-1587411",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAXONOMY",
            "identifier": "111N00000X",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WORKMAN'S COMPENSATION",
            "identifier": "C09649-7",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in North Tonawanda, NY
• Providers in North Tonawanda, NY by specialty
• Chiropractor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2014; 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.