Individual provider Active NPI

John David Brockway, D.C.

  • Chiropractor
  • Denver, CO
National Provider Identifier
1760612634
Registry record updated Aug 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
6392 Issued in CO
Practice address
425 S Cherry St
Ste. 307
Denver, CO 80246-1226
Phone
(720) 889-1659
Fax
(720) 889-2873
NPI assigned
Jul 24, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 6392 CO Primary

Addresses

Primary practice location

425 S Cherry St
Ste. 307
Denver, CO 80246-1226

Mailing address

425 S Cherry St
Suite 307
Denver, CO 80246
Phone (720) 889-1659

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100226000162 CO Practitioner - Chiropractic 0648315838 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

425 S Cherry St
Suite 307
Denver, CO 80246-1226

425 S Cherry St
Suite 307
Denver, CO 80246-1230
Phone (720) 889-1659

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6392COMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Brockway Chiropractic Chiropractor CurrentSince Dec 22, 2009 Accepting new patients
Tranquility Chiropractic & Wellness Chiropractor PastSince Aug 23, 2020 Accepting new patients

Locations

425 S Cherry St
Ste 307
Denver, CO 80246
Phone (720) 889-1659

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1248393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597190400000",
    "number": "1760612634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 S CHERRY ST",
            "address_2": "SUITE 307",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "80246",
            "telephone_number": "720-889-1659",
            "fax_number": "720-889-2873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 S CHERRY ST",
            "address_2": "STE. 307",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802461226",
            "telephone_number": "720-889-1659",
            "fax_number": "720-889-2873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCKWAY",
        "first_name": "JOHN",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-24",
        "last_updated": "2020-08-12",
        "certification_date": "2020-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CO",
            "license": "6392",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2020; 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.