NPIMap

Organization Active NPI

Faircloth Chiropractic Clinic, L.L.C.

  • Chiropractor
  • Alexandria, LA
National Provider Identifier
1982857561
Registry record updated Nov 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
915 Issued in LA
Legal business name
FAIRCLOTH CHIROPRACTIC CLINIC, L.L.C.
Practice address
3620 Bayou Rapides Rd
Alexandria, LA 71303-3653
Phone
(318) 448-8462
Fax
(318) 448-8486
NPI assigned
Oct 28, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2008

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

Authorized official

Name
Dr. Kelly Boisvert Faircloth, DCNPI 1083674402
Title
Chiropractor/Owner
Phone
(318) 448-8462

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 915 LA Primary

Addresses

Primary practice location

3620 Bayou Rapides Rd
Alexandria, LA 71303-3653

Mailing address

3620 Bayou Rapides Rd
Alexandria, LA 71303-3653
Phone (318) 448-8462

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090323000105 LA Part B Supplier - Clinic/Group Practice 7012074875 Receives reassigned benefits from 3 practitioners
Practice locations: Alexandria, LA

National Provider Directory

National Provider Directory

Locations

3620 Bayou Rapides Rd
Alexandria, LA 71303
Phone (318) 448-8462

11 Heyman Ln
Alexandria, LA 71303
Phone (318) 445-0419

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1225152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225929600000",
    "number": "1982857561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3620 BAYOU RAPIDES RD",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713033653",
            "telephone_number": "318-448-8462",
            "fax_number": "318-448-8486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3620 BAYOU RAPIDES RD",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713033653",
            "telephone_number": "318-448-8462",
            "fax_number": "318-448-8486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRCLOTH CHIROPRACTIC CLINIC, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-28",
        "last_updated": "2008-11-06",
        "status": "A",
        "authorized_official_last_name": "FAIRCLOTH",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "BOISVERT",
        "authorized_official_title_or_position": "CHIROPRACTOR/OWNER",
        "authorized_official_telephone_number": "318-448-8462",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "LA",
            "license": "915",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2008; 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.