Organization Active NPI

Brainwire LLC

  • Neurology Physician
  • Lafayette, LA
National Provider Identifier
1548826803
Registry record updated Mar 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
BRAINWIRE LLC
Practice address
128 Keeneland LN
Lafayette, LA 70503-6213
Phone
(337) 739-7037
NPI assigned
May 13, 2019
Last updated
Mar 30, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2022

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

Authorized official

Name
Dr. Adam Foreman, MDNPI 1013132323
Title
Owner
Phone
(337) 739-7037

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
Neurology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084N0400X Primary

Addresses

Primary practice location

128 Keeneland LN
Lafayette, LA 70503-6213

Mailing address

2851 Johnston St
PMB 512
Lafayette, LA 70503-3243

Other identifiers 1

IdentifierTypeStateIssuer
1013132323OtherNPI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190604003330 LA Part B Supplier - Clinic/Group Practice 4486987591 Receives reassigned benefits from 1 practitioner
Practice locations: Lafayette, LA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1557705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648598400000",
    "number": "1548826803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2851 JOHNSTON ST",
            "address_2": "PMB 512",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705033243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 KEENELAND LN",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705036213",
            "telephone_number": "337-739-7037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRAINWIRE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-13",
        "last_updated": "2022-03-30",
        "certification_date": "2022-03-24",
        "status": "A",
        "authorized_official_last_name": "FOREMAN",
        "authorized_official_first_name": "ADAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "337-739-7037",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1013132323",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2022; 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.