Organization Active NPI

Kelly M. Brown, D.C., Inc.

  • Chiropractor
  • Grapevine, TX
National Provider Identifier
1235548561
Registry record updated Aug 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4205 Issued in TX
Legal business name
KELLY M. BROWN, D.C., INC.
Practice address
800 Ira E Woods Ave
Grapevine, TX 76051-5538
Phone
(817) 481-7025
Fax
(817) 481-9621
NPI assigned
Aug 12, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2014

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

Authorized official

Name
Dr. Kelly Brown, D.C.NPI 1760593149
Title
Owner
Phone
(817) 481-7025

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 4205 TX Primary

Addresses

Primary practice location

800 Ira E Woods Ave
Grapevine, TX 76051-5538

Mailing address

800 Ira E Woods Ave
Grapevine, TX 76051-5538
Phone (817) 481-7025

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140911000834 TX Part B Supplier - Clinic/Group Practice 8628297330 Receives reassigned benefits from 2 practitioners
Practice locations: Grapevine, TX

National Provider Directory

National Provider Directory

Locations

800 Ira E Woods Ave
Grapevine, TX 76051
Phone (817) 481-7025

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": "1407801600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1407801600000",
    "number": "1235548561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 IRA E WOODS AVE",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760515538",
            "telephone_number": "817-481-7025",
            "fax_number": "817-481-9621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 IRA E WOODS AVE",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760515538",
            "telephone_number": "817-481-7025",
            "fax_number": "817-481-9621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KELLY M. BROWN, D.C., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-12",
        "last_updated": "2014-08-12",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-481-7025",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "4205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grapevine, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2014; 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.