NPIMap

Organization Active NPI

Brauchla Family Chiropractic Professional Corporation

  • Chiropractor
  • Anderson, IN
National Provider Identifier
1083898514
Registry record updated Oct 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
08002193A Issued in IN
Legal business name
BRAUCHLA FAMILY CHIROPRACTIC PROFESSIONAL CORPORATION
Practice address
523 W 38TH St
Anderson, IN 46013-4021
Phone
(765) 642-7246
Fax
(765) 642-6986
NPI assigned
Dec 19, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2016

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

Authorized official

Name
Mrs. Kelly Ann Brauchla, DCNPI 1912990185
Title
Chiropractor
Phone
(765) 642-7246

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X 08002193A IN Primary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X 2301008788 MI
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X 08002181A IN

Addresses

Primary practice location

523 W 38TH St
Anderson, IN 46013-4021

Mailing address

523 W 38TH St
Anderson, IN 46013-4021
Phone (765) 642-7246

Other identifiers 1

IdentifierTypeStateIssuer
200512770AMedicaidIN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050602000850 IN Part B Supplier - Clinic/Group Practice 5092758805 Receives reassigned benefits from 2 practitioners
Practice locations: Anderson, IN

National Provider Directory

National Provider Directory

Locations

523 W 38th St
Anderson, IN 46013
Phone (765) 642-7246

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1198022400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475625600000",
    "number": "1083898514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "523 W 38TH ST",
            "city": "ANDERSON",
            "state": "IN",
            "postal_code": "460134021",
            "telephone_number": "765-642-7246",
            "fax_number": "765-642-6986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "523 W 38TH ST",
            "city": "ANDERSON",
            "state": "IN",
            "postal_code": "460134021",
            "telephone_number": "765-642-7246",
            "fax_number": "765-642-6986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRAUCHLA FAMILY CHIROPRACTIC PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-19",
        "last_updated": "2016-10-05",
        "status": "A",
        "authorized_official_last_name": "BRAUCHLA",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "765-642-7246",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "08002193A",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301008788",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "08002181A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200512770A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anderson, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2016; 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.