Active NPI
Brian Kent Llewellyn, DC
- Chiropractor
- Romeo, MI
National Provider Identifier
1861664237
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 2301006643
- Practice address
- 122 S Rawles Street
Suite 112
Romeo, MI 48065-5177 - Phone
- (586) 752-6111
- NPI assigned
- Mar 26, 2008
- Sex
- Male
- Sole proprietor
- Yes
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 | 2301006643 | MI | Primary |
Addresses
Primary practice location
122 S Rawles Street
Suite 112
Romeo, MI 48065-5177
Mailing address
122 S Rawles Street
Suite 112
Romeo, MI 48065-5177
Phone (586) 752-6111
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 950E05220 | Other | MI | BLUE CROSS BLUE SHIELD |
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 |
|---|---|---|---|
| 2301006643 | MI | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1206489600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1206489600000",
"number": "1861664237",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "122 S RAWLES STREET",
"address_2": "SUITE 112",
"city": "ROMEO",
"state": "MI",
"postal_code": "480655177",
"telephone_number": "586-752-6111"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "122 S RAWLES STREET",
"address_2": "SUITE 112",
"city": "ROMEO",
"state": "MI",
"postal_code": "480655177",
"telephone_number": "586-752-6111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LLEWELLYN",
"first_name": "BRIAN",
"middle_name": "KENT",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-03-26",
"last_updated": "2008-03-26",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MI",
"license": "2301006643",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "950E05220",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Romeo, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.