Organization Active NPI

Brew Chiropractic, a Professional Corporation

  • Chiropractor
  • San Diego, CA
National Provider Identifier
1710215082
Registry record updated Feb 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC31109 Issued in CA
Legal business name
BREW CHIROPRACTIC, A PROFESSIONAL CORPORATION
Practice address
3110 Camino del Rio S Ste 310
San Diego, CA 92108-3832
Phone
(619) 299-7222
Fax
(858) 278-7055
NPI assigned
Nov 25, 2009
Last updated
Feb 4, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2024

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

Authorized official

Name
Dr. Kristine Kay Brew, D.C.NPI 1184863318
Title
President
Phone
(619) 299-9722

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 DC31109 CA Primary

Addresses

Primary practice location

3110 Camino del Rio S Ste 310
San Diego, CA 92108-3832

Mailing address

3110 Camino del Rio S Ste 310
San Diego, CA 92108-3832
Phone (619) 299-7222

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100628000346 CA Part B Supplier - Clinic/Group Practice 2163553652 Receives reassigned benefits from 1 practitioner
Practice locations: San Diego, CA

National Provider Directory

National Provider Directory

Locations

3110 Camino del Rio S
Ste 310
San Diego, CA 92108
Phone (619) 299-7222

3900 5th Ave
Ste 230
San Diego, CA 92103
Phone (619) 299-9722

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1259107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707004800000",
    "number": "1710215082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3110 CAMINO DEL RIO S STE 310",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083832",
            "telephone_number": "619-299-7222",
            "fax_number": "858-278-7055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3110 CAMINO DEL RIO S STE 310",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083832",
            "telephone_number": "619-299-7222",
            "fax_number": "858-278-7055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BREW CHIROPRACTIC, A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-25",
        "last_updated": "2024-02-04",
        "certification_date": "2024-02-04",
        "status": "A",
        "authorized_official_last_name": "BREW",
        "authorized_official_first_name": "KRISTINE",
        "authorized_official_middle_name": "KAY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "619-299-9722",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC31109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2024; 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.