Individual provider Active NPI

Adam Wayne Roussel, D.C.

  • Chiropractor
  • Destrehan, LA
National Provider Identifier
1457623654
Registry record updated Mar 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1641 Issued in LA
Practice address
1972 Ormond Blvd Ste a
Destrehan, LA 70047-3812
Phone
(985) 307-0977
Fax
(859) 307-0984
NPI assigned
Feb 2, 2012
Last updated
Mar 13, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1641 LA Primary

Addresses

Primary practice location

1972 Ormond Blvd Ste a
Destrehan, LA 70047-3812

Mailing address

1972 Ormond Blvd Ste a
Destrehan, LA 70047-3812
Phone (985) 307-0977

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120430000748 LA Practitioner - Chiropractic 8123280674 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1972 Ormond Blvd
Suite a
Destrehan, LA 70047-3812
Phone (985) 307-0977

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Adam Roussel Inc Chiropractor CurrentSince Jan 20, 2012 Accepting new patients
Adam Roussel, Inc. Past Accepting new patients

Locations

1974 N Highway 190
Covington, LA 70433
Phone (985) 871-7411

1972 Ormond Blvd
Ste A
Destrehan, LA 70047
Phone (985) 307-0977

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1328140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741824000000",
    "number": "1457623654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1972 ORMOND BLVD STE A",
            "city": "DESTREHAN",
            "state": "LA",
            "postal_code": "700473812",
            "telephone_number": "985-307-0977",
            "fax_number": "985-307-0984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1972 ORMOND BLVD STE A",
            "city": "DESTREHAN",
            "state": "LA",
            "postal_code": "700473812",
            "telephone_number": "985-307-0977",
            "fax_number": "859-307-0984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROUSSEL",
        "first_name": "ADAM",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-02-02",
        "last_updated": "2025-03-13",
        "certification_date": "2025-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "LA",
            "license": "1641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Destrehan, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2025; 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.