Organization Active NPI

R E B 3 Inc

Doing business as Busch Chiropractic Clinic

  • Chiropractor
  • Fort Wayne, IN
National Provider Identifier
1881819845
Registry record updated Jan 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
08001648 Issued in IN
Legal business name
R E B 3 INC
Doing business as
Busch Chiropractic Clinic
Practice address
5005 Riviera CT
Fort Wayne, IN 46825-5805
Phone
(260) 471-4090
Fax
(260) 471-9919
NPI assigned
Apr 16, 2007
Last updated
Jan 5, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2024

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

Authorized official

Name
Dr. Richard E. Busch III, D.C.NPI 1477612141
Title
President
Phone
(260) 471-4090

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 08001648 IN Primary

Addresses

Primary practice location

5005 Riviera CT
Fort Wayne, IN 46825-5805

Mailing address

5005 Riviera CT
Fort Wayne, IN 46825-5805
Phone (260) 471-4090

Other names 1

  • Busch Chiropractic Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111121000607 IN Part B Supplier - Clinic/Group Practice 5698728616 Receives reassigned benefits from 2 practitioners
Practice locations: Fort Wayne, IN

National Provider Directory

National Provider Directory

Locations

5005 Riviera Ct
Fort Wayne, IN 46825
Phone (219) 484-9604

Practitioners & affiliated clinicians

Practitioners 4

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": "1176681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704412800000",
    "number": "1881819845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5005 RIVIERA CT",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468255805",
            "telephone_number": "260-471-4090",
            "fax_number": "260-471-9919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5005 RIVIERA CT",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468255805",
            "telephone_number": "260-471-4090",
            "fax_number": "260-471-9919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "R E B 3 INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-16",
        "last_updated": "2024-01-05",
        "certification_date": "2024-01-05",
        "status": "A",
        "authorized_official_last_name": "BUSCH",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "260-471-4090",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "08001648",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Busch Chiropractic Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Wayne, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2024; 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.