Individual provider Active NPI

Anjenette M. Brightman, D.C.

  • Chiropractor
  • Bryan, OH
National Provider Identifier
1902955602
Registry record updated Mar 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2956 Issued in OH
Practice address
05539 State Route 15
Bryan, OH 43506-8874
Phone
(419) 636-3133
Fax
(419) 636-3188
NPI assigned
Jan 10, 2007
Last updated
Mar 27, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2956 OH Primary

Addresses

Primary practice location

05539 State Route 15
Bryan, OH 43506-8874

Mailing address

05539 State Route 15
PO Box 566
Bryan, OH 43506-8874
Phone (419) 636-3133

Other identifiers 3

IdentifierTypeStateIssuer
2183702MedicaidOH
350049884OtherOHRAILROAD MEDICARE
000000142171OtherOHANTHEM BCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120120000671 OH Practitioner - Chiropractic 6709989833 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Brightman Family Tree Chiropractic LLCGroup PAC ID 2264535392, 2 clinicians

Practice addresses (Care Compare)

05539 State Route 15
Bryan, OH 43506-8874
Phone (419) 636-3133

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2956OHMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Brightman Family Tree Chiropractic LLC Chiropractor CurrentSince Mar 13, 2000 Accepting new patients

Locations

05539 State Route 15
Bryan, OH 43506
Phone (419) 636-3133

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395878400000",
    "number": "1902955602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "05539 STATE ROUTE 15",
            "address_2": "PO BOX 566",
            "city": "BRYAN",
            "state": "OH",
            "postal_code": "435068874",
            "telephone_number": "419-636-3133",
            "fax_number": "419-636-3188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "05539 STATE ROUTE 15",
            "city": "BRYAN",
            "state": "OH",
            "postal_code": "435068874",
            "telephone_number": "419-636-3133",
            "fax_number": "419-636-3188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRIGHTMAN",
        "first_name": "ANJENETTE",
        "middle_name": "M.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-10",
        "last_updated": "2014-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "2956",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2183702",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "350049884",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000142171",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryan, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2014; 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.