BRIAN G HACKLEMAN (NPI# 1053358291) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053358291 |
| Entity Type | Individual |
| Full Name | BRIAN G HACKLEMAN |
| Credential | DC |
| Practice Address |
341 S Springfield Ave Bolivar MO 65613-2040 |
| Practice Telephone | 4173263527 |
| Practice Fax Number | 4173263529 |
| Mailing Telephone | 4173263527 |
| Mailing Fax Number | 4173263529 |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2018-04-18 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | 006529 | MO | Chiropractic Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | MEDICARE PTAN | 000025678 | 01 |
| MO | BCBS OF MO | 188731 | 01 |
| Street Address |
341 S SPRINGFIELD AVE |
| City | BOLIVAR |
| State | MO |
| Zip Code | 65613-2040 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497242192 | Brian G. Hackleman, D.c., L.L.C. | Chiropractor | 341 S Springfield Ave, Bolivar, MO 65613-2040 | 2018-04-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891301552 | Casablanca Care Center, LLC | Home Health | 524 S. Albany Avenue, Bolivar, MO 65613 | 2020-09-18 |
| 1669087045 | Revive Medical LLC | Durable Medical Equipment & Medical Supplies | 5000, S Scenic, Bolivar, MO 65613 | 2020-09-11 |
| 1669097119 | Melanie Nicole Beckham | Nurse Practitioner | 1100 South Springfield Ave, Suite B, Bolivar, MO 65613 | 2020-06-10 |
| 1932754744 | Caitlin M Williams | Specialist/Technologist | 1260 S Pike Avenue, Bolivar, MO 65613 | 2019-08-08 |
| 1073022406 | Jacquelyn Rose Kemnic | Dietitian, Registered | Heart Center, 1500 N Oakland Ave, Willard, MO 65613 | 2017-09-28 |
| 1164897161 | Ozarks Resource Group | Clinic/Center | 203 E. Broadway St., Bolivar, MO 65613 | 2015-12-02 |
| 1962895292 | Professional Christian Counseling | Counselor | 4888 S 139th Road, Bolivar, MO 65613 | 2015-03-11 |
| 1073916573 | Scott Leslie Dennis | Physician Assistant | 1500 North Oakland Ave, Citizens Memorial Hospital, Bolivar, MO 65613 | 2014-09-29 |
| 1053712109 | Citizens Memorial Hospital District | Pharmacy | 1301-b North Oakland, Bolivar, MO 65613 | 2014-09-09 |
| 1740680453 | Jamee M Stimpson | Occupational Therapist | 454 S. Main Avenue, Bolivar, MO 65613 | 2014-08-29 |
| Find all providers in zip 65613 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225283633 | Chiropractic Health and Wellness Center LLC | Chiropractor | 495 S Main Ave, Suite C, Bolivar, MO 65613-2126 | 2008-11-26 |
| 1295939205 | Gerard Isaac Porter | Chiropractor | 495 S Main Ave Ste C, Bolivar, MO 65613-2126 | 2007-06-13 |
| 1437378726 | Alma Christine Potter | Chiropractor | 3367 S Springfield Ave, Bolivar, MO 65613-9132 | 2007-04-25 |
| 1194881169 | Carl L Blomenkamp | Chiropractor | 2853 W Broadway St, Bolivar, MO 65613-3379 | 2006-12-27 |
| 1437105798 | Brian G Hackleman Dc | Chiropractor | 800 E Aldrich Rd, Bolivar, MO 65613 | 2006-05-26 |
| 1639129513 | William Wray Emley Jr. | Chiropractor | 10948 State Route 212 Ne, Suite A, Bolivar, OH 44612 | 2006-05-11 |
| 1770532376 | Emley Family Chiropractic Inc | Chiropractor | 387 Edgebrook Blvd, Bolivar, OH 44612-8769 | 2006-05-09 |
| 1639128291 | Kelly Anne Farrell | Chiropractor | 387 Edgebrook Rd Ne, Bolivar, OH 44612-8706 | 2006-05-09 |
| 1497242192 | Brian G. Hackleman, D.c., L.L.C. | Chiropractor | 341 S Springfield Ave, Bolivar, MO 65613-2040 | 2018-04-18 |
| 1811164312 | Health and Wellness Chiropractic Center, LLC | Chiropractor | 3367 S Springfield Ave, Bolivar, MO 65613-9132 | 2008-05-14 |
| Find all providers in BOLIVAR | ||||
Please comment or provide details below to improve the information on BRIAN G HACKLEMAN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.