Individual provider Active NPI

Kellie Lynette Kulow, D.C.

  • Chiropractor
  • Brenham, TX
National Provider Identifier
1043229032
Registry record updated Apr 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
9361 Issued in TX
Practice address
218 E Main St
Brenham, TX 77833-3780
Phone
(979) 830-7055
Fax
(979) 836-8168
NPI assigned
Aug 7, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 18, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 9361 TX Primary

Addresses

Primary practice location

218 E Main St
Brenham, TX 77833-3780

Mailing address

218 E Main St
Brenham, TX 77833-3780
Phone (979) 830-7055

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060427000708 TX Practitioner - Chiropractic 9436169927 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2305 Becker Dr
Suite F
Brenham, TX 77833-5700
Phone (979) 830-7055

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9361TXMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Kulow Chiropractic & Wellness Center PLLC Chiropractor CurrentSince Feb 2, 2019 Accepting new patients
La Grange Chiropractic Clinic PA Chiropractor Past Accepting new patients
Legacy Physical Therapy and Wellness LLC PastSince Jun 4, 2021 Accepting new patients

Locations

3855 Highway 36 N
Ste 103
Brenham, TX 77833
Phone (979) 830-7055

218 E Main St
Brenham, TX 77833
Phone (979) 830-7055

2305 Becker Dr
Ste F
Brenham, TX 77833

851 E Travis St
La Grange, TX 78945
Phone (979) 732-3900

464 E Guadalupe St
La Grange, TX 78945
Phone (979) 966-0601

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1154908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460937600000",
    "number": "1043229032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "218 E MAIN ST",
            "city": "BRENHAM",
            "state": "TX",
            "postal_code": "778333780",
            "telephone_number": "979-830-7055",
            "fax_number": "979-836-8168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "218 E MAIN ST",
            "city": "BRENHAM",
            "state": "TX",
            "postal_code": "778333780",
            "telephone_number": "979-830-7055",
            "fax_number": "979-836-8168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KULOW",
        "first_name": "KELLIE",
        "middle_name": "LYNETTE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-07",
        "last_updated": "2016-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "9361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brenham, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2016; 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.