Individual provider Active NPI

Brian McKenna, D.C.

  • Chiropractor
  • Wrentham, MA
National Provider Identifier
1821168782
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2705 Issued in MA
Practice address
46 South St
Wrentham, MA 02093
Phone
(508) 384-0944
NPI assigned
Nov 8, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2705 MA Primary

Addresses

Primary practice location

46 South St
Wrentham, MA 02093

Mailing address

560 Chestnut St
Franklin, MA 02038

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060504000795 MA Practitioner - Chiropractic 4587674569 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Absolute Health Chiropractic PCGroup PAC ID 8527138544, 2 clinicians

Practice addresses (Care Compare)

685 S St
Suite F
Wrentham, MA 02093-1516
Phone (508) 384-0944

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2705MAMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Absolute Health Chiropractic. P.C. Chiropractor CurrentSince Mar 1, 2008 Accepting new patients

Locations

46 South St
Wrentham, MA 02093
Phone (508) 384-0944

685 South St
Ste F
Wrentham, MA 02093
Phone (508) 384-0944

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1821168782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560 CHESTNUT ST",
            "city": "FRANKLIN",
            "state": "MA",
            "postal_code": "02038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "46 SOUTH ST",
            "city": "WRENTHAM",
            "state": "MA",
            "postal_code": "02093",
            "telephone_number": "508-384-0944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKENNA",
        "first_name": "BRIAN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MA",
            "license": "2705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wrentham, MA

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.
  • 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.