NPIMap

Organization Active NPI

Brent M. Smith, D.C. a Chiropractic Corporation

  • Chiropractor
  • Irvine, CA
National Provider Identifier
1902115579
Registry record updated Sep 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC16153 Issued in CA
Legal business name
BRENT M. SMITH, D.C. A CHIROPRACTIC CORPORATION
Practice address
4200 Trabuco Rd
Suite 180
Irvine, CA 92620-3600
Phone
(949) 552-1172
Fax
(949) 552-8172
NPI assigned
Sep 30, 2010
Last updated
Sep 30, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2010

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

Authorized official

Name
Dr. Brent Myron Smith, D.C.NPI 1013924299
Title
President
Phone
(949) 552-1172

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 DC16153 CA Primary

Addresses

Primary practice location

4200 Trabuco Rd
Suite 180
Irvine, CA 92620-3600

Mailing address

4200 Trabuco Rd
Suite 180
Irvine, CA 92620-3600
Phone (949) 552-1172

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101004000477 CA Part B Supplier - Clinic/Group Practice 2163614637 Receives reassigned benefits from 1 practitioner
Practice locations: Irvine, CA

National Provider Directory

National Provider Directory

Locations

14978 Sand Canyon Ave
Ste C
Irvine, CA 92618
Phone (949) 552-1172

4200 Trabuco Rd
Ste 180
Irvine, CA 92620
Phone (949) 552-1172

Practitioners & affiliated clinicians

Practitioners 9

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": "1285804800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285804800000",
    "number": "1902115579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 TRABUCO RD",
            "address_2": "SUITE 180",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926203600",
            "telephone_number": "949-552-1172",
            "fax_number": "949-552-8172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 TRABUCO RD",
            "address_2": "SUITE 180",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926203600",
            "telephone_number": "949-552-1172",
            "fax_number": "949-552-8172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRENT M. SMITH, D.C. A CHIROPRACTIC CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-30",
        "last_updated": "2010-09-30",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "BRENT",
        "authorized_official_middle_name": "MYRON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "949-552-1172",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC16153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2010; 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.