NPIMap

Organization Active NPI

Broman Chiropractic Clinic PA

  • Chiropractor
  • Maple Grove, MN
National Provider Identifier
1710125562
Registry record updated Apr 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2312 Issued in MN
Legal business name
BROMAN CHIROPRACTIC CLINIC PA
Practice address
7237 Forestview LN N
Maple Grove, MN 55369-5501
Phone
(763) 420-8595
NPI assigned
Feb 2, 2009
Last updated
Apr 1, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2009

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

Authorized official

Name
Dr. Douglas Broman, DCNPI 1962598052
Title
Clinic Director
Phone
(763) 420-8595

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2312 MN Primary

Addresses

Primary practice location

7237 Forestview LN N
Maple Grove, MN 55369-5501

Mailing address

7237 Forestview LN N
Maple Grove, MN 55369-5501
Phone (763) 420-8595

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090402000195 MN Part B Supplier - Clinic/Group Practice 5799832002 Receives reassigned benefits from 4 practitioners
Practice locations: Maple Grove, MN

National Provider Directory

National Provider Directory

Locations

7237 Forestview Ln N
Maple Grove, MN 55369
Phone (763) 420-8595

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1233532800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1238544000000",
    "number": "1710125562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7237 FORESTVIEW LN N",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553695501",
            "telephone_number": "763-420-8595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7237 FORESTVIEW LN N",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553695501",
            "telephone_number": "763-420-8595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROMAN CHIROPRACTIC CLINIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-02",
        "last_updated": "2009-04-01",
        "status": "A",
        "authorized_official_last_name": "BROMAN",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_title_or_position": "CLINIC DIRECTOR",
        "authorized_official_telephone_number": "763-420-8595",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "2312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maple Grove, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 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.