Individual provider Active NPI

Brian John Broskoskie, DC

  • Chiropractor
  • Dagsboro, DE
National Provider Identifier
1942361035
Registry record updated Apr 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
F1-924 Issued in DE
Practice address
30838 Vines Creek Rd
Suite 2 a
Dagsboro, DE 19939-4385
Phone
(302) 408-0000
Fax
(302) 358-2453
NPI assigned
Dec 12, 2006
Last updated
Apr 1, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X F1-924 DE Primary

Addresses

Primary practice location

30838 Vines Creek Rd
Suite 2 a
Dagsboro, DE 19939-4385

Mailing address

30838 Vines Creek Rd
Suite 2 a
Dagsboro, DE 19939-4385
Phone (302) 404-0000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F1-924DEMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Delmarva Health Centre, Inc Chiropractor PastSince Feb 5, 2016 Accepting new patients

Organizations & group practices 2

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": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491004800000",
    "number": "1942361035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30838 VINES CREEK RD",
            "address_2": "SUITE 2 A",
            "city": "DAGSBORO",
            "state": "DE",
            "postal_code": "199394385",
            "telephone_number": "302-404-0000",
            "fax_number": "302-358-2453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30838 VINES CREEK RD",
            "address_2": "SUITE 2 A",
            "city": "DAGSBORO",
            "state": "DE",
            "postal_code": "199394385",
            "telephone_number": "302-408-0000",
            "fax_number": "302-358-2453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROSKOSKIE",
        "first_name": "BRIAN",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-12",
        "last_updated": "2017-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "DE",
            "license": "F1-924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dagsboro, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.