Independent US Healthcare Provider Directory & Public Medical Database
Deactivated NPI 1669454039 Deactivated / Inactive NPI Male Practitioner

Dr. Brian C Eder , DC

Chiropractor • Fort Drum, NY

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Brian Eder has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date November 18, 2005
NPI Deactivation Date March 09, 2018
Total Practice Duration ~13 Years of Practice (2005 – 2018)

Professional Overview & Biography Verified Profile Summary

Dr. Brian Eder, DC was a registered Chiropractor practicing in Fort Drum, NY. Throughout an active medical career spanning 13 years, Dr. Eder provided care at the practice location at 11050 MT BELVEDERE BLVD until profile deactivation on 2018-03-09.

Practice Location & Contact Primary Location

Practice Address

11050 Mt Belvedere Blvd
Usa Meddac Attn Credentials

Fort Drum, NY 136025004

Telephone 3157724025
Fax 3157729498

Specialty Benchmarks & Practice Insights

Comparative analytics for Chiropractor in Fort Drum, NY

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 28.5 Yrs
Regional Practice Density
3 Specialists

Practicing in Fort Drum, NY (4796 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Chiropractor Primary Specialty

NUCC Taxonomy Code: 111N00000X

State License NY X009071

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.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
NPI 1043283419

Doctor of Medicine (M.D.)

David Hartley , PA-C

Physician Assistant

NPI 1063498665

Physician Assistant (Certified)

David Paul

Optometrist

NPI 1063664720
Dr. Scott Carow , DPT

Physical Therapist

NPI 1083715213

Doctor of Physical Therapy

John Cadin , LCSW

Social Worker - Clinical

NPI 1093967937

Licensed Clinical Social Worker

Erin Favret , PTA

Physical Therapy Assistant

NPI 1104083013

Physical Therapist Assistant

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

12 Historical Events
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NPI Profile Deactivated March 09, 2018

Record deactivated on March 09, 2018

NPI Profile Active July 26, 2017

NPI status registered as active in NPPES database

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Updated Practice Location July 26, 2017

Registered at 3030 SAWTELLE BLVD, LOS ANGELES, CA 900661408 (Tel: 3103909018)

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Updated Business Mailing Address July 26, 2017

Registered at 3030 SAWTELLE BLVD, LOS ANGELES, CA 90066 (Tel: 13103909018)

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Provider Name / Credentials Updated July 26, 2017

Recorded as BRIAN EDER, DC

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 26, 2017

Chiropractor (License #32867 in CA)

NPI Profile Active April 09, 2014

NPI status registered as active in NPPES database

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Updated Practice Location April 09, 2014

Registered at 11050 MT BELVEDERE BLVD, USA MEDDAC ATTN CREDENTIALS, FORT DRUM, NY 136025004 (Tel: 3157724025)

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Updated Business Mailing Address April 09, 2014

Registered at 11050 MT BELVEDERE BLVD, USA MEDDAC ATTN CREDENTIALS, FORT DRUM, NY 136025004 (Tel: 3157724025)

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Provider Name / Credentials Updated April 09, 2014

Recorded as BRIAN EDER, DC

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Medical Taxonomy / Specialty Registered (Primary Specialty) April 09, 2014

Chiropractor (License #X009071 in NY)

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Initial NPI Registration & Enumeration November 18, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1669454039
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: November 18, 2005
Last Update: April 09, 2014
Deactivation Date: March 09, 2018

Mailing Address

11050 Mt Belvedere Blvd, Usa Meddac Attn Credentials

Fort Drum, NY 136025004

Phone: 3157724025

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.