Active NPI
Brianna Wilson
- Chiropractor
- Longmont, CO
National Provider Identifier
1629892302
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 111N00000X
- Practice address
- 1601 Kimbark St Unit 103
Longmont, CO 80501-2860 - Phone
- (207) 974-8312
- NPI assigned
- Nov 11, 2024
- 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 | 111N00000X | CO | Primary |
Addresses
Primary practice location
1601 Kimbark St Unit 103
Longmont, CO 80501-2860
Mailing address
1601 Kimbark St Unit 103
Longmont, CO 80501-2860
Phone (207) 974-8312
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 111N00000X | CO | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1731283200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1731283200000",
"number": "1629892302",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1601 KIMBARK ST UNIT 103",
"city": "LONGMONT",
"state": "CO",
"postal_code": "805012860",
"telephone_number": "207-974-8312"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1601 KIMBARK ST UNIT 103",
"city": "LONGMONT",
"state": "CO",
"postal_code": "805012860",
"telephone_number": "207-974-8312"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "BRIANNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-11-11",
"last_updated": "2024-11-11",
"certification_date": "2024-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CO",
"license": "111N00000X",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Longmont, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.