Organization Active NPI

Franklin County Chiropractic Clinic, Inc

  • Sports Physician Chiropractor
  • Brookville, IN
National Provider Identifier
1972676435
Registry record updated Jan 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
License
08007533 Issued in IN
Legal business name
FRANKLIN COUNTY CHIROPRACTIC CLINIC, INC
Practice address
1235 Franklin Ave
Brookville, IN 47012-1037
Phone
(765) 647-5332
Fax
(765) 647-5332
NPI assigned
Nov 15, 2006
Last updated
Jan 21, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2015

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

Authorized official

Name
Dr. Daniel Paul Bukofchan, D.C.NPI 1134124290
Title
President
Phone
(765) 647-5332

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physician ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111NS0005X 08007533 IN Primary

Addresses

Primary practice location

1235 Franklin Ave
Brookville, IN 47012-1037

Mailing address

1235 Franklin Ave
P O Box 387
Brookville, IN 47012-1037
Phone (765) 647-5332

Other identifiers 1

IdentifierTypeStateIssuer
100365400AMedicaidIN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050204000414 IN Part B Supplier - Clinic/Group Practice 4587615786 Receives reassigned benefits from 1 practitioner
Practice locations: Brookville, IN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421798400000",
    "number": "1972676435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1235 FRANKLIN AVE",
            "address_2": "P O BOX 387",
            "city": "BROOKVILLE",
            "state": "IN",
            "postal_code": "470121037",
            "telephone_number": "765-647-5332",
            "fax_number": "765-647-5332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1235 FRANKLIN AVE",
            "city": "BROOKVILLE",
            "state": "IN",
            "postal_code": "470121037",
            "telephone_number": "765-647-5332",
            "fax_number": "765-647-5332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRANKLIN COUNTY CHIROPRACTIC CLINIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-15",
        "last_updated": "2015-01-21",
        "status": "A",
        "authorized_official_last_name": "BUKOFCHAN",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "765-647-5332",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Sports Physician",
            "state": "IN",
            "license": "08007533",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100365400A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.