Individual provider Active NPI

Joshua Allen Holbrook, D.C.

  • Chiropractor
  • Baxter, MN
National Provider Identifier
1972848844
Registry record updated Dec 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5714 Issued in MN
Practice address
15574 Edgewood Dr
Suite 102
Baxter, MN 56401-6955
Phone
(218) 829-2665
Fax
(218) 829-4855
NPI assigned
Dec 4, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 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 5714 MN Primary

Addresses

Primary practice location

15574 Edgewood Dr
Suite 102
Baxter, MN 56401-6955

Mailing address

15574 Edgewood Dr
Suite 102
Baxter, MN 56401-6955
Phone (218) 829-2665

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130131000433 MN Practitioner - ChiropracticPractitioner - Other (Physician) 7517111479 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Holbrook Family Chiropractic PLLCGroup PAC ID 4587691712, 5 clinicians

Practice addresses (Care Compare)

15574 Edgewood Dr
Suite 102
Baxter, MN 56401-6956
Phone (218) 829-2665

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Holbrook Family Chiropractic PLLC Chiropractor CurrentSince Dec 3, 2012 Accepting new patients

Locations

15574 Edgewood Dr
Ste 102
Brainerd, MN 56401
Phone (218) 829-2665

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1354579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354579200000",
    "number": "1972848844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15574 EDGEWOOD DR",
            "address_2": "SUITE 102",
            "city": "BAXTER",
            "state": "MN",
            "postal_code": "564016955",
            "telephone_number": "218-829-2665",
            "fax_number": "218-829-4855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15574 EDGEWOOD DR",
            "address_2": "SUITE 102",
            "city": "BAXTER",
            "state": "MN",
            "postal_code": "564016955",
            "telephone_number": "218-829-2665",
            "fax_number": "218-829-4855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLBROOK",
        "first_name": "JOSHUA",
        "middle_name": "ALLEN",
        "name_prefix": "Mr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-12-04",
        "last_updated": "2012-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "5714",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baxter, MN

Sources for this page

Verify at the official NPI Registry.