Active NPI
Bruce K Resnick, D.C.
- Rehabilitation Chiropractor
- Gilbert, AZ
National Provider Identifier
1760692255
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Chiropractor
- License
- 5756
- Practice address
- 4915 E Baseline Road
Suite 101
Gilbert, AZ 85234-2966 - Phone
- (480) 926-7100
- Fax
- (480) 926-7101
- NPI assigned
- May 23, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rehabilitation Chiropractor | 111NR0400X | 5756 | AZ | Primary |
Addresses
Primary practice location
4915 E Baseline Road
Suite 101
Gilbert, AZ 85234-2966
Mailing address
4915 E Baseline Road
Suite 101
Gilbert, AZ 85234-2966
Phone (480) 926-7100
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| AZ0243120 | Other | AZ | BLUE CROSS BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179878400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1208217600000",
"number": "1760692255",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4915 E BASELINE ROAD",
"address_2": "SUITE 101",
"city": "GILBERT",
"state": "AZ",
"postal_code": "852342966",
"telephone_number": "480-926-7100",
"fax_number": "480-926-7101"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4915 E BASELINE ROAD",
"address_2": "SUITE 101",
"city": "GILBERT",
"state": "AZ",
"postal_code": "852342966",
"telephone_number": "480-926-7100",
"fax_number": "480-926-7101"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RESNICK",
"first_name": "BRUCE",
"middle_name": "K",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-23",
"last_updated": "2008-04-15",
"status": "A"
},
"taxonomies": [
{
"code": "111NR0400X",
"taxonomy_group": "",
"desc": "Chiropractor, Rehabilitation",
"state": "AZ",
"license": "5756",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "AZ0243120",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Gilbert, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.