DR. BRIAN SCOTT KELLEY (NPI# 1811994205) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811994205 |
| Entity Type | Individual |
| Full Name | DR. BRIAN SCOTT KELLEY |
| Credential | DC |
| Practice Address |
1503 Larson St Bloomer WI 54724-1632 |
| Practice Telephone | 7155684220 |
| Practice Fax Number | 7155684201 |
| Mailing Telephone | 7155684220 |
| Mailing Fax Number | 7155684201 |
| Enumeration Date | 2005-06-30 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111NS0005X |
Chiropractor Specialization: Sports Physician |
2014-012 | WI | Chiropractic Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 38796100 | 05 | |
| WI | BCBS | 392035966010 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598027054 | Brian P Kelley | Licensed Practical Nurse | 98 Chapman Ave, Auburn, NY 13021-4632 | 2012-06-11 |
| 1265706949 | Brian Edward Kelley | Social Worker | 139-141 North St., Suite 303, Pittsfield, MA 01201 | 2012-02-28 |
| 1770866261 | Brian Thomas Kelley | Pharmacist | 1380 S Appomattox Ave, Republic, MO 65738-7802 | 2011-09-21 |
| 1326352022 | Brian L Kelley | Pharmacist | 970 N Main Rd, Vineland, NJ 08360-8266 | 2010-08-05 |
| 1821165465 | Brian Kelley | Chiropractor | 6096 Se Federal Hwy, Stuart, FL 34997-8101 | 2006-11-29 |
| 1366423527 | Brian Patrick Kelley | Dentist | 6923 W Becher St, West Allis, WI 53219-1353 | 2005-11-07 |
| 1003811407 | Brian Kelley | Obstetrics & Gynecology | 7500 Hospital Dr, Dublin, OH 43016-8518 | 2005-06-14 |
| 1194213785 | Brian Kelley | Student in an Organized Health Care Education/Training Program | 102 Mason Farm Rd, Chapel Hill, NC 27599-6134 | 2018-04-29 |
| 1063958395 | Brian R Kelley | Counselor | 3400 S Washington Rd, Saginaw, MI 48601-4958 | 2017-01-10 |
| 1891147336 | Brian Kelley | Nurse Practitioner | 300 Flynn Ave, Burlington, VT 05401-5301 | 2016-07-08 |
| Street Address |
1503 LARSON ST |
| City | BLOOMER |
| State | WI |
| Zip Code | 54724-1632 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548305022 | Kelley Chiropractic, S.c. | Chiropractor | 1503 Larson St, Bloomer, WI 54724-1632 | 2007-02-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093064545 | Robin Lachance | Physical Therapy Assistant | 1731 17th Avenue, Bloomer, WI 54724 | 2012-08-30 |
| 1104051614 | Nancy L Stiehm | Home Health Aide | 721 Priddy St, Bloomer, WI 54724 | 2009-05-28 |
| 1508013566 | Dianne Marie Goettl | Reflexologist | 1610 Main Street, Bloomer, WI 54724 | 2008-08-21 |
| 1609956481 | Timothy John Peterson | Chiropractor | 10135 Hwy Ss, Bloomer, WI 54724 | 2006-10-16 |
| 1427058122 | Ronald J Reimer | Physician Assistant | 1501 Thompson St, Bloomer, WI 54724 | 2005-07-26 |
| 1851827752 | Kimberly Carol Nicolai | Physical Therapist | 1501 Thompson St, Bloomer, WI 54724 | 2017-05-11 |
| 1639430788 | Celestine Chukwunonso Odenigbo | Internal Medicine | 1501 Thompson St, Bloomer, WI 54724 | 2012-06-05 |
| 1124250436 | Tania Riske | Speech-Language Pathologist | 1501 Thompson St, Bloomer, WI 54724 | 2009-08-20 |
| 1922230259 | Amy Sue Hilbert | Speech-Language Pathologist | 1501 Thompson St, Bloomer, WI 54724 | 2009-08-20 |
| 1659527281 | Janki Natu Patel | Internal Medicine | 1501 Thompson St, Bloomer, WI 54724 | 2008-08-14 |
| Find all providers in zip 54724 | ||||
| Taxonomy Code | 111NS0005X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| Specialization | Sports Physician |
| A sports chiropractor is uniquely trained to provide care and treatment of injuries or illness resulting from sports and physical fitness activities. Doctors of Chiropractic with the Diplomate American Chiropractic Board of Sports Physicians (DACBSP) or the Certified Chiropractic Sports Physician (CCSP), sport specialty certifications from the American Chiropractic Board of Sports Physicians, have advanced training in the assessment, management and rehabilitation of sports related injuries. Extremity care, rehabilitation and soft tissue procedures are common skills utilized by these doctors. The specialty training covers a broad spectrum from the pediatric athlete to professional and Olympic athletes, and everything in between, using a variety of techniques and modalities. |
| Notes: Source: American Chiropractic Board of Sports Physicians, 2009 [7/1/2009: definition added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548305022 | Kelley Chiropractic, S.c. | Chiropractor | 1503 Larson St, Bloomer, WI 54724-1632 | 2007-02-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346658903 | Winneconne Chiropractic and Sports Rehab LLC | Chiropractor | 238 W Main Street, Winneconne, WI 54986 | 2014-07-28 |
| 1760727937 | Frederick Knight Sheppard | Chiropractor | 2649 Bay Settlement Rd, Green Bay, WI 54311-7328 | 2012-11-29 |
| 1306102066 | Imagine Chiropractic and Wellness Center, Inc. | Chiropractor | 445 Cardinal Ln Ste 110, Green Bay, WI 54313-9577 | 2012-04-06 |
| 1609146182 | Grace E Zuiker Nash | Chiropractor | 5829 Birch Ln, Rhinelander, WI 54501-8986 | 2011-12-30 |
| 1477724276 | Washa Chiropractic Clinic, Inc. | Chiropractor | 1415 State Road 16, La Crosse, WI 54601-2980 | 2008-03-19 |
| 1235318585 | Newcare Integrated Health Services, S.c. | Chiropractor | 1366 Appleton Rd, Suite A, Menasha, WI 54952-1504 | 2007-11-02 |
| 1114126570 | Jay J Meverden | Chiropractor | 2600 Stewart Ave Ste 154, Wausau, WI 54401-1404 | 2007-07-16 |
| 1679785729 | Twit Chiropractic Clinic, S.c. | Chiropractor | 3125 Main Street, Stevens Point, WI 54481 | 2007-05-03 |
| 1750507885 | Taylor Chiropractic & Sports Injury Center, S.c. | Chiropractor | 153 E Jefferson St, Spring Green, WI 53588 | 2007-04-17 |
| 1851425052 | William E Atkinson | Chiropractor | 1344 Creston Park Dr, Janesville, WI 53545-1113 | 2007-03-16 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.