Brennon H Kelly, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

1820 Issued in LA

Practice address

805 Albertson Pkwy Ste B
Broussard, LA 70518-4350

Phone

(337) 257-3253

NPI assigned

Mar 9, 2018

Last updated

Apr 10, 2019By the provider in NPPES

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 LA

Enrollment records 1

Specialty

Chiropractic

Education

Life Chiropractic College, 2017

Medicare assignment

May accept Medicare assignment

Group practices

Rise Chiropractic, LLCGroup PAC ID 5395087845, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Rise Chiropractic, LLC

  • Chiropractor
  • Broussard, LA
  • NPI 1780188169
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1520553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554854400000",
    "number": "1023511680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 ALBERTSON PKWY STE B",
            "city": "BROUSSARD",
            "state": "LA",
            "postal_code": "705184350",
            "telephone_number": "337-257-3253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 ALBERTSON PKWY STE B",
            "city": "BROUSSARD",
            "state": "LA",
            "postal_code": "705184350",
            "telephone_number": "337-257-3253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "BRENNON",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-03-09",
        "last_updated": "2019-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "LA",
            "license": "1820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Denise Ann Jordan, LPN
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• Nam Kar
• Katie L Simon LCSW
• Kay's Unlimited Care
• Oy Keobupha, PHARMD
• L & L Medical & Diagnostic Center, LLC
• Labry Family Dentistry
• Shelli Alyse Lacombe, D.C.
• Lafayette Health Ventures, Inc (Executive Health)

• Chiropractor in Broussard, LA
• Providers in Broussard, LA by specialty
• Chiropractor in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2019; 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.