Brian J. Fillmore, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

1440 Issued in TN

Practice address

1260 Gallaher Rd Ste a-C
Kingston, TN 37763-4139

Phone

(865) 248-8167

Fax

(865) 248-8125

NPI assigned

Dec 18, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Active Family & Sports Chiropractic PLLC

  • Chiropractor
  • Kingston, TN
  • NPI 1336423334
  NPD (past)
• Brown Chiropractic

  • Chiropractor
  • Knoxville, TN
  • NPI 1023056645
  NPD (past)

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694044800000",
    "number": "1699838037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1364 INTERSTATE DR STE 101",
            "city": "CROSSVILLE",
            "state": "TN",
            "postal_code": "385556187",
            "telephone_number": "931-456-8880",
            "fax_number": "931-456-8883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1260 GALLAHER RD STE A-C",
            "city": "KINGSTON",
            "state": "TN",
            "postal_code": "377634139",
            "telephone_number": "865-248-8167",
            "fax_number": "865-248-8125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FILLMORE",
        "first_name": "BRIAN",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-18",
        "last_updated": "2023-09-07",
        "certification_date": "2023-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NN1001X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Nutrition",
            "state": "OH",
            "license": "3009",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TN",
            "license": "1440",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5233596",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACN UNITED HEALTH CARE",
            "identifier": "663526",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q085835",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC BS",
            "identifier": "000000393235",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tara Helen Ericson, DDS
• Kerri Nicole Everson, D.D.S.
• Eye Care Centers PLLC
• Eye Care Centers PLLC
• Amanda Smith Ferguson, FNP
• Rebecca Michelle Fitzgerald, APRN, NP-C
• Miranda Beck Fleming, M.S. CCC-SLP
• Kathy D. Fowler, L.C.S.W.
• Wayne King Fritts, DDS
• Leonard Ray Fuqua Jr., DDS, MS

• Chiropractor in Kingston, TN
• Providers in Kingston, TN by specialty
• Chiropractor in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2023; 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.