Individual provider Active NPI

Lucas Patrick Bromley, D C

  • Chiropractor
  • Indianapolis, IN
National Provider Identifier
1972542876
Registry record updated Aug 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
08002269A Issued in IN
Practice address
3820 N High School Rd
Indianapolis, IN 46254-2709
Phone
(317) 299-3330
Fax
(317) 299-0404
NPI assigned
Jun 6, 2006
Last updated
Aug 18, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 08002269A IN Primary

Addresses

Primary practice location

3820 N High School Rd
Indianapolis, IN 46254-2709

Mailing address

3820 N High School Rd
Indianapolis, IN 46254-2709
Phone (317) 299-3330

Other identifiers 1

IdentifierTypeStateIssuer
00000561620OtherINANTHEM

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070109000428 IN Practitioner - Chiropractic 2567462963 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3820 N High School Rd
Indianapolis, IN 46254-2709
Phone (317) 299-3330

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
08002269AINMDChiropractor

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": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282089600000",
    "number": "1972542876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3820 N HIGH SCHOOL RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462542709",
            "telephone_number": "317-299-3330",
            "fax_number": "317-299-0404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3820 N HIGH SCHOOL RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462542709",
            "telephone_number": "317-299-3330",
            "fax_number": "317-299-0404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROMLEY",
        "first_name": "LUCAS",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "D C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2010-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "08002269A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "00000561620",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2010; 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.