Bradley I Simon, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH8265 Issued in FL

Practice address

8771 NW 50TH St
Lauderhill, FL 33351-5403

Phone

(954) 688-3440

Fax

(954) 323-2401

NPI assigned

Jan 27, 2006

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 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1138320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595462400000",
    "number": "1720059959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8771 NW 50TH ST",
            "city": "LAUDERHILL",
            "state": "FL",
            "postal_code": "333515403",
            "telephone_number": "954-688-3440",
            "fax_number": "954-323-2401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8771 NW 50TH ST",
            "city": "LAUDERHILL",
            "state": "FL",
            "postal_code": "333515403",
            "telephone_number": "954-688-3440",
            "fax_number": "954-323-2401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMON",
        "first_name": "BRADLEY",
        "middle_name": "I",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-27",
        "last_updated": "2020-07-23",
        "certification_date": "2020-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH8265",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3819302",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Lauderhill, FL
• Providers in Lauderhill, FL by specialty
• Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2020; 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.