Individual provider Active NPI

Kayla Marie Jentes, DC

  • Chiropractor
  • Selma, NC
National Provider Identifier
1861075624
Registry record updated Apr 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5279 Issued in NC
Practice address
102 W Anderson St
Selma, NC 27576-2562
Phone
(919) 351-5787
NPI assigned
Apr 29, 2021
Last updated
Apr 29, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5279 NC Primary

Addresses

Primary practice location

102 W Anderson St
Selma, NC 27576-2562

Mailing address

102 W Anderson St
Selma, NC 27576-2562
Phone (919) 351-5787

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230523000212 NC Practitioner - Chiropractic 8325404072 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Brio Wellness PLLC Chiropractor CurrentSince Jan 4, 2023 Accepting new patients

Locations

102 W Anderson St
Selma, NC 27576
Phone (919) 351-5787

805 N Pollock St
Selma, NC 27576
Phone (919) 351-5787

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": "1619654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619654400000",
    "number": "1861075624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 W ANDERSON ST",
            "city": "SELMA",
            "state": "NC",
            "postal_code": "275762562",
            "telephone_number": "919-351-5787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 W ANDERSON ST",
            "city": "SELMA",
            "state": "NC",
            "postal_code": "275762562",
            "telephone_number": "919-351-5787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENTES",
        "first_name": "KAYLA",
        "middle_name": "MARIE",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-29",
        "last_updated": "2021-04-29",
        "certification_date": "2021-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "5279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Selma, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2021; 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.