Brock Johnson, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

16072 Issued in AR

Practice address

2630 E Citizens Dr Ste 6
Fayetteville, AR 72703-4797

Phone

(479) 935-3021

Fax

(479) 777-9921

NPI assigned

Feb 24, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Specialty

Chiropractic

Education

Cleveland Chiropractic College - Kansas City, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Johnson Chiropractic Center, LLC

  • Chiropractor
  • Fayetteville, AR
  • NPI 1154811412
  Medicare reassignment Authorized official
• Michael Waggoner OD PA

  • Health Maintenance Organization
  • Fayetteville, AR
  • NPI 1992021190
  NPD

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

{
    "created_epoch": "1424736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668038400000",
    "number": "1992197180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1583 MAIN DR",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727045214",
            "telephone_number": "479-443-0800",
            "fax_number": "479-443-5535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2630 E CITIZENS DR STE 6",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727034797",
            "telephone_number": "479-935-3021",
            "fax_number": "479-777-9921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "BROCK",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-02-24",
        "last_updated": "2022-11-10",
        "certification_date": "2022-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AR",
            "license": "16072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abigail Speights Johnson, APRN-PMHNP
• Allison M Johnson, M.D.
• Amanda Kelly Johnson, P.T., D.P.T.
• Amy K Johnson, MHPP
• Briana Michele Johnson
• Charles Chad Johnson, D.D.S.
• Diane McKinney Johnson, M.S.R.D.L.D.
• Evan Michael Johnson, DDS
• Gail R Johnson, DPM
• Hannah Johnson

• Chiropractor in Fayetteville, AR
• Providers in Fayetteville, AR by specialty
• Chiropractor in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2022; 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.