Brennan Fife Bushman, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

DC011772 Issued in PA

Practice address

15 Barbour St
Bradford, PA 16701-1978

Phone

(814) 368-1100

NPI assigned

Jul 13, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1594598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660521600000",
    "number": "1730707043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54 HEDGEHOG LN",
            "city": "BRADFORD",
            "state": "PA",
            "postal_code": "167012611",
            "telephone_number": "801-455-6107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 BARBOUR ST",
            "city": "BRADFORD",
            "state": "PA",
            "postal_code": "167011978",
            "telephone_number": "814-368-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSHMAN",
        "first_name": "BRENNAN",
        "middle_name": "FIFE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-13",
        "last_updated": "2022-08-15",
        "certification_date": "2022-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "UT",
            "license": "11827629-1202",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC011772",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Breznik, MD
• BRMS OB/GYN
• Andrew Mark Brodis, DMD
• Matthew Buck
• Nichole D Burritt, LMHC
• Jill Lorryn Campbell, SPEECH-LANGUAGE PATH
• Bryan A. Cannon, R.N.
• Care for Children
• Curtis G Carlisle, COTA
• Ashley Rene Carlson, MOT, OTR/L

• Chiropractor in Bradford, PA
• Providers in Bradford, PA by specialty
• Chiropractor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.