NPIMap

Organization Active NPI

Coyle Chiropractic Corp.

  • Chiropractor
  • San Jose, CA
National Provider Identifier
1811916000
Registry record updated May 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC15169 Issued in CA
Legal business name
COYLE CHIROPRACTIC CORP.
Practice address
3315 Almaden Expy Ste 20
San Jose, CA 95118-1557
Phone
(408) 264-6644
Fax
(408) 264-3515
NPI assigned
Jul 19, 2006
Last updated
May 30, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 30, 2020

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

Authorized official

Name
Dr. Brian Edward Coyle, D.C.NPI 1417029612
Title
President
Phone
(408) 264-6644

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC15169 CA Primary
Chiropractor 111N00000X DC20945 CA
Internal Medicine Physician 207R00000X 20A6277 CA

Addresses

Primary practice location

3315 Almaden Expy Ste 20
San Jose, CA 95118-1557

Mailing address

3315 Almaden Expy Ste 20
San Jose, CA 95118-1557
Phone (408) 264-6644

Other identifiers 2

IdentifierTypeStateIssuer
DC20945OtherCASTATE LICENSE NUMBER
DC15169OtherCASTATE LICENSE NUMBER

Other names 1

  • Coyle Chiropractic Inc Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101103000645 CA Part B Supplier - Clinic/Group Practice 8426152695 Receives reassigned benefits from 6 practitioners
Practice locations: San Jose, CA

National Provider Directory

National Provider Directory

Locations

591 W Hamilton Ave
Ste 160
Campbell, CA 95008
Phone (408) 264-6644

3315 Almaden Expy
Ste 20
San Jose, CA 95118
Phone (408) 264-6644

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1590796800000",
    "number": "1811916000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3315 ALMADEN EXPY STE 20",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951181557",
            "telephone_number": "408-264-6644",
            "fax_number": "408-264-3515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3315 ALMADEN EXPY STE 20",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951181557",
            "telephone_number": "408-264-6644",
            "fax_number": "408-264-3515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COYLE CHIROPRACTIC CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-19",
        "last_updated": "2020-05-30",
        "certification_date": "2020-05-30",
        "status": "A",
        "authorized_official_last_name": "COYLE",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "408-264-6644",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC15169",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC20945",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "20A6277",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "DC20945",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "DC15169",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Coyle Chiropractic Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Coyle Chiropractic Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2020; 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.