Individual provider Active NPI

Brianna Mercedes Audelo, DC

  • Chiropractor
  • La Verne, CA
National Provider Identifier
1851046965
Registry record updated Feb 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC36289 Issued in CA
Practice address
3841 Emerald Ave
La Verne, CA 91750-2904
Phone
(909) 301-0141
NPI assigned
Feb 16, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC36289 CA Primary

Addresses

Primary practice location

3841 Emerald Ave
La Verne, CA 91750-2904

Mailing address

3841 Emerald Ave
La Verne, CA 91750-2904
Phone (909) 301-0141

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

LicenseStateTypeSpecialty
DC36289CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Brittany Anne Burkhart Chiropractor CurrentSince May 16, 2022 Accepting new patients

Locations

3841 Emerald Ave
La Verne, CA 91750
Phone (909) 301-0141

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1644969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644969600000",
    "number": "1851046965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3841 EMERALD AVE",
            "city": "LA VERNE",
            "state": "CA",
            "postal_code": "917502904",
            "telephone_number": "909-301-0141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3841 EMERALD AVE",
            "city": "LA VERNE",
            "state": "CA",
            "postal_code": "917502904",
            "telephone_number": "909-301-0141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AUDELO",
        "first_name": "BRIANNA",
        "middle_name": "MERCEDES",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-16",
        "last_updated": "2022-02-16",
        "certification_date": "2022-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC36289",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Verne, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.