Kelly B. Faircloth, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

915 Issued in LA

Practice address

11 Heyman LN
Alexandria, LA 71303-3574

Phone

(318) 448-8462

Fax

(318) 448-8486

NPI assigned

Mar 28, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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 and National Provider Directory roles.

• Faircloth Chiropractic Clinic, L.L.C.

  • Chiropractor
  • Alexandria, LA
  • NPI 1982857561
  Medicare reassignment NPD Authorized official
• R. a. Boisvert, D.C.

  • Chiropractor
  • Alexandria, LA
  • NPI 1730395781
  NPD (past)

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

{
    "created_epoch": "1143504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568246400000",
    "number": "1083674402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 HEYMAN LN",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713033574",
            "telephone_number": "318-448-8462",
            "fax_number": "318-448-8486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 HEYMAN LN",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713033574",
            "telephone_number": "318-448-8462",
            "fax_number": "318-448-8486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAIRCLOTH",
        "first_name": "KELLY",
        "middle_name": "B.",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-28",
        "last_updated": "2019-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "LA",
            "license": "915",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1936294",
            "state": "LA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Alexandria",
            "affiliation": "N",
            "address_1": "11 Heyman Ln",
            "city": "Alexandria",
            "state": "LA",
            "country_code": "US",
            "postal_code": "713033574",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Eyemart Express LLC
• Eyemart Express, LTD.
• Johnson Sullivan Fairbanks, RPH
• Faircloth Chiropractic Clinic, L.L.C.
• Camille Faircloth, DC
• Fairway Counseling Agency, Inc.
• Fairway Counseling, Inc
• Fairway Counseling, LLC
• Faith and Hope of Alexandria
• Faith Foundation Hospice

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2019; 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.