Bre Chiropractic

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

4875-12 Issued in WI

Legal business name

BRE CHIROPRACTIC

Practice address

621 S Gammon Rd
Madison, WI 53719-1371

Phone

(608) 630-9040

Fax

(608) 630-9060

NPI assigned

Mar 20, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Breanna R Ballweg, DCNPI 1467727826

Title

Chiropractor

Phone

(608) 630-9040

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Breanna Rose Ballweg, D.C.

  • Chiropractor
  • Madison, WI
  • NPI 1467727826
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1332201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1345075200000",
    "number": "1942575287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 S GAMMON RD",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537191371",
            "telephone_number": "608-630-9040",
            "fax_number": "608-630-9060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 S GAMMON RD",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537191371",
            "telephone_number": "608-630-9040",
            "fax_number": "608-630-9060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRE CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-20",
        "last_updated": "2012-08-16",
        "status": "A",
        "authorized_official_last_name": "BALLWEG",
        "authorized_official_first_name": "BREANNA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "608-630-9040",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "4875-12",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100022189",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ORGANIZATION PTAN",
            "identifier": "W12807",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "W12807001",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erin Bravo, M.D.
• Andrea Braxton, RN
• Felish Desha Braxton, RN
• Thomas B Brazelton, MD MPH
• Zachary Brazgel, PHARMD
• Kaylee Kassandra Brea, DMD
• Nikki L Brechtel, AA-C
• Don E Breckbill, MD
• Greta Marie Breckbill, AUD
• Stacy Brecke, DPT

• Chiropractor in Madison, WI
• Providers in Madison, WI by specialty
• Chiropractor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 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.