Bret R Staley Chiropractic LTD

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

B506 Issued in NV

Legal business name

BRET R STALEY CHIROPRACTIC LTD

Practice address

1170 N Moapa Valley Blvd
Ste C
Overton, NV 89040-1350

Phone

(702) 397-2273

Fax

(702) 397-2705

NPI assigned

Jan 26, 2007

Organization subpart

No

Name

Bret R Staley, DCNPI 1205005030

Title

Pres Sec Treas

Phone

(702) 397-2273

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

• Bret R Staley, DC

  • Chiropractor
  • Overton, NV
  • NPI 1205005030
  Medicare reassignment NPD Authorized official

Medicare fee-for-service enrollment

Enrolled in NV

Enrollment records 1

• Moapa Valley Chiropractic Doing business as

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 6, 2008.

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204761600000",
    "number": "1992851489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1350",
            "city": "OVERTON",
            "state": "NV",
            "postal_code": "890401350",
            "telephone_number": "702-397-2273",
            "fax_number": "702-397-2705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1170 N MOAPA VALLEY BLVD",
            "address_2": "STE C",
            "city": "OVERTON",
            "state": "NV",
            "postal_code": "890401350",
            "telephone_number": "702-397-2273",
            "fax_number": "702-397-2705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRET R STALEY CHIROPRACTIC LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-26",
        "last_updated": "2008-03-06",
        "status": "A",
        "authorized_official_last_name": "STALEY",
        "authorized_official_first_name": "BRET",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRES SEC TREAS",
        "authorized_official_telephone_number": "702-397-2273",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NV",
            "license": "B506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Moapa Valley Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Payden Blake Anderson, DMD
• Todd J Askeroth, DC
• Kent Jay Bennion, O.D.
• Terry Buhecker
• Adam Crawford, LCSW
• Robert J. Grow, MPT
• Randall L Jensen, OD
• Timothy Johnson, PHARMD

• All providers in Overton, NV
• Chiropractor in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2008; 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.