Individual provider Active NPI

Kyle Daniel Brown, D.C.

  • Chiropractor
  • Decatur, IL
National Provider Identifier
1740652569
Registry record updated Sep 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038013256 Issued in IL
Practice address
1200 E Pershing Rd
Decatur, IL 62526-4729
Phone
(217) 875-3010
NPI assigned
Oct 21, 2015
Last updated
Sep 3, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038013256 IL Primary

Addresses

Primary practice location

1200 E Pershing Rd
Decatur, IL 62526-4729

Mailing address

1200 E Pershing Rd
Decatur, IL 62526-4729
Phone (217) 875-3010

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241022002250 IL Practitioner - Chiropractic 5890097711 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1200 E Pershing Rd
Decatur, IL 62526-4729
Phone (217) 875-3010

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038013256ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Sheila J Woodrow PC Chiropractor CurrentSince Sep 8, 2024 Accepting new patients
217 Chiropractic LLC Chiropractor CurrentSince Sep 3, 2024 Accepting new patients

Locations

1200 E Pershing Rd
Decatur, IL 62526
Phone (217) 875-3010

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1445385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725321600000",
    "number": "1740652569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 E PERSHING RD",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625264729",
            "telephone_number": "217-875-3010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 E PERSHING RD",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625264729",
            "telephone_number": "217-875-3010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "KYLE",
        "middle_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-10-21",
        "last_updated": "2024-09-03",
        "certification_date": "2024-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038013256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2024; 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.