Active NPI
Kelly Jean Burwell, D.C.
- Chiropractor
- Clarksville, TN
National Provider Identifier
1629145826
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- DC795
- Practice address
- 664 Sango Rd
Clarksville, TN 37043-5489 - Phone
- (931) 368-1996
- Fax
- (931) 368-0448
- NPI assigned
- Nov 30, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | DC795 | TN | Primary |
Addresses
Primary practice location
664 Sango Rd
Clarksville, TN 37043-5489
Mailing address
3719 Tarsus Rd
Palmyra, TN 37142-2103
Phone (931) 326-9241
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 133736 | Other | TN | BLUE CROSS BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DC795 | TN | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164844800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1629145826",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3719 TARSUS RD",
"city": "PALMYRA",
"state": "TN",
"postal_code": "371422103",
"telephone_number": "931-326-9241"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "664 SANGO RD",
"city": "CLARKSVILLE",
"state": "TN",
"postal_code": "370435489",
"telephone_number": "931-368-1996",
"fax_number": "931-368-0448"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURWELL",
"first_name": "KELLY",
"middle_name": "JEAN",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-30",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "TN",
"license": "DC795",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "133736",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Clarksville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.