Individual provider Active NPI

Kelly Larson-Brunner, D.C.

  • Chiropractor
  • Westbrook, ME
National Provider Identifier
1508953464
Registry record updated Dec 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CR1284 Issued in ME
Practice address
89 Larrabee Rd
Westbrook, ME 04092-4744
Phone
(207) 854-2001
Fax
(207) 854-2004
NPI assigned
Oct 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CR1284 ME Primary

Addresses

Primary practice location

89 Larrabee Rd
Westbrook, ME 04092-4744

Mailing address

89 Larrabee Rd
Westbrook, ME 04092-4744
Phone (207) 854-2001

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050602001024 ME Practitioner - Chiropractic 2668415498 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Cleveland Chiropractic College - Kansas City, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New England Chiropractic, LLCGroup PAC ID 3476552662, 3 clinicians

Practice addresses (Care Compare)

89 Larrabee Rd
Westbrook, ME 04092-4744
Phone (207) 854-2001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
New England Chiropractic, LLC Chiropractor CurrentSince Jan 7, 2002 Accepting new patients

Locations

89 Larrabee Rd
Westbrook, ME 04092
Phone (207) 854-2001

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450310400000",
    "number": "1508953464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "89 LARRABEE RD",
            "city": "WESTBROOK",
            "state": "ME",
            "postal_code": "040924744",
            "telephone_number": "207-854-2001",
            "fax_number": "207-854-2004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "89 LARRABEE RD",
            "city": "WESTBROOK",
            "state": "ME",
            "postal_code": "040924744",
            "telephone_number": "207-854-2001",
            "fax_number": "207-854-2004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON-BRUNNER",
        "first_name": "KELLY",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-10",
        "last_updated": "2015-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ME",
            "license": "CR1284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westbrook, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2015; 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.