Bernard Keenum, LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

BERNARD KEENUM, LLC

Practice address

11505 Cinema Dr Ste 7
Diberville, MS 39540-9703

Phone

(228) 365-0449

Fax

(228) 365-2314

NPI assigned

Apr 16, 2020

Last updated

Apr 16, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Bernard Joseph Keenum, DCNPI 1760654925

Title

Managing Member

Phone

(228) 337-0440

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Bernard Joseph Keenum, D.C.

  • Chiropractor
  • D'Iberville, MS
  • NPI 1760654925
  NPD Authorized official

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

{
    "created_epoch": "1586995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586995200000",
    "number": "1376163683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11505 CINEMA DR STE 7",
            "city": "DIBERVILLE",
            "state": "MS",
            "postal_code": "395409703",
            "telephone_number": "228-365-0449",
            "fax_number": "228-365-2314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11505 CINEMA DR STE 7",
            "city": "DIBERVILLE",
            "state": "MS",
            "postal_code": "395409703",
            "telephone_number": "228-365-0449",
            "fax_number": "228-365-2314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BERNARD KEENUM, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-16",
        "last_updated": "2020-04-16",
        "certification_date": "2020-04-16",
        "status": "A",
        "authorized_official_last_name": "KEENUM",
        "authorized_official_first_name": "BERNARD",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "228-337-0440",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.