Individual provider Active NPI

Brandon Christopher Wong, D.C.

  • Chiropractor
  • Phoenix, AZ
National Provider Identifier
1942415229
Registry record updated Oct 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
7826 Issued in AZ
Practice address
1619 E McDowell Rd Ste C
Phoenix, AZ 85006-4458
Phone
(602) 334-1064
Fax
(602) 354-3655
NPI assigned
May 11, 2007
Last updated
Oct 5, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 7826 AZ Primary

Addresses

Primary practice location

1619 E McDowell Rd Ste C
Phoenix, AZ 85006-4458

Mailing address

1619 E McDowell Rd Ste C
Phoenix, AZ 85006-4458
Phone (602) 334-1064

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131010001781 AZ Practitioner - Chiropractic 9436383163 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 2007
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1619 E McDowell Rd
Suite B
Phoenix, AZ 85006-4458
Phone (602) 334-1064

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

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": "1178841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349395200000",
    "number": "1942415229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1619 E MCDOWELL RD STE C",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850064458",
            "telephone_number": "602-334-1064",
            "fax_number": "602-354-3655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1619 E MCDOWELL RD STE C",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850064458",
            "telephone_number": "602-334-1064",
            "fax_number": "602-354-3655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "BRANDON",
        "middle_name": "CHRISTOPHER",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-11",
        "last_updated": "2012-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "7826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2012; 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.