Individual provider Active NPI

Brian Richard Anderson, DC, MPH

  • Chiropractor
  • Chicago, IL
National Provider Identifier
1811903354
Registry record updated Jan 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038-010322 Issued in IL
Practice address
150 E Huron St
Suite 1100
Chicago, IL 60611-2999
Phone
(312) 926-1593
NPI assigned
Aug 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038-010322 IL Primary

Addresses

Primary practice location

150 E Huron St
Suite 1100
Chicago, IL 60611-2999

Mailing address

150 E Huron St
Suite 1100
Chicago, IL 60611-2999
Phone (312) 926-1593

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050309000538 IL Practitioner - Chiropractic 9133173479 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038-010322ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
National University of Health Sciences Chiropractor CurrentSince Mar 21, 2011 Accepting new patients
Northwestern Memorial Physicians Group Chiropractor Past Accepting new patients
Martin Avenue Chiropractic & Wellness S.C Past Accepting new patients

Locations

200 E Roosevelt Rd
Lombard, IL 60148
Phone (630) 629-9664

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/11209/brand/1/csg/1/fhir/r4

Organizations & group practices 3

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": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1232064000000",
    "number": "1811903354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 E HURON ST",
            "address_2": "SUITE 1100",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112999",
            "telephone_number": "312-926-1593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 E HURON ST",
            "address_2": "SUITE 1100",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112999",
            "telephone_number": "312-926-1593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "BRIAN",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "DC, MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2009-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038-010322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.