Individual provider Active NPI

Robert D Brown, DC

  • Chiropractor
  • Bloomington, IL
National Provider Identifier
1881694859
Registry record updated Aug 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038-009333 Issued in IL
Practice address
2422 E Washington St
Suite 202
Bloomington, IL 61704-4478
Phone
(309) 663-9900
Fax
(309) 663-9901
NPI assigned
Jul 29, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038-009333 IL Primary

Addresses

Primary practice location

2422 E Washington St
Suite 202
Bloomington, IL 61704-4478

Mailing address

2422 E Washington St
Suite 202
Bloomington, IL 61704-4478
Phone (309) 663-9900

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050629000443 IL Practitioner - Chiropractic 9234175340 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 2000
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2422 E Washington St
Suite 202
Bloomington, IL 61704-1611
Phone (309) 663-9900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038-009333ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Elite Chiropractic and Rehabilitation Center, LTD. Chiropractor CurrentSince Oct 10, 2011 Accepting new patients
Forward Living LTD Chiropractor Past Accepting new patients
Brown Chiropractic Center, LTD. Chiropractor Past Accepting new patients

Locations

2422 E Washington St
Ste 2
Bloomington, IL 61704

2422 E Washington St
Ste 202
Bloomington, IL 61704
Phone (309) 663-9900

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": "1122595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313712000000",
    "number": "1881694859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2422 E WASHINGTON ST",
            "address_2": "SUITE 202",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617044478",
            "telephone_number": "309-663-9900",
            "fax_number": "309-663-9901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2422 E WASHINGTON ST",
            "address_2": "SUITE 202",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617044478",
            "telephone_number": "309-663-9900",
            "fax_number": "309-663-9901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "ROBERT",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-29",
        "last_updated": "2011-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038-009333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2011; 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.