Brian Gordon, DC, LAC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

DC-29620 Issued in CA

Practice address

5363 Balboa Blvd
Suite 436
Encino, CA 91316-2805

Phone

(818) 386-8835

NPI assigned

Dec 21, 2006

Last updated

Jun 17, 2016By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Chiropractic

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Brian Gordon DC Lac Acupuncture Professional Corporation

  dba Active Care Spine Center

  • Chiropractor
  • Encino, CA
  • NPI 1629271846
  Medicare reassignment NPD Authorized official
• Joint Effort Medical Wellness

  • Other Technician
  • Beverly Hills, CA
  • NPI 1740462837
  NPD (past)

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466121600000",
    "number": "1750445821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5363 BALBOA BLVD STE 436",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913162840",
            "telephone_number": "818-386-8835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5363 BALBOA BLVD",
            "address_2": "SUITE 436",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913162805",
            "telephone_number": "818-386-8835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "BRIAN",
        "credential": "DC, LAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-21",
        "last_updated": "2016-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC-29620",
            "primary": true
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC-13010",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "DC29620",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christopher Genaro Goodelle
• Alan Martin Goodman, PHD
• Stanley Louis Goodman
• Nicole Goodrum
• Gordon & Silvers Ods
• Kristen Rachelle Gordon, PT, DPT
• Mark Lorry Gordon, M.D.
• Gabriel Goren, MD
• Stephen Irwin Gorlick, D.D.S.
• Martin Neil Gorman, D.D.S.

• Chiropractor in Encino, CA
• Providers in Encino, CA by specialty
• Chiropractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2016; 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.