Individual provider Active NPI

Dwayne Allen Brouse, DC

  • Chiropractor
  • Charlotte, NC
National Provider Identifier
1801987938
Registry record updated Mar 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3389 Issued in NC
Practice address
10032 Warwickshire LN
Charlotte, NC 28270-2566
Phone
(704) 840-4556
NPI assigned
Sep 27, 2006
Last updated
Mar 13, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3389 NC Primary
Chiropractor 111N00000X S02177 MD

Addresses

Primary practice location

10032 Warwickshire LN
Charlotte, NC 28270-2566

Mailing address

10032 Warwickshire Lane
Charlotte, NC 28270
Phone (704) 845-5958

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

State licenses

LicenseStateTypeSpecialty
3389NCMDProfessional Counselor
S02177MDMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205366400000",
    "number": "1801987938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10032 WARWICKSHIRE LANE",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28270",
            "telephone_number": "704-845-5958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10032 WARWICKSHIRE LN",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282702566",
            "telephone_number": "704-840-4556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROUSE",
        "first_name": "DWAYNE",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2008-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "3389",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MD",
            "license": "S02177",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 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.

Verify at the official NPI Registry.