Organization Active NPI

Hembree Chiropractic PA

  • Chiropractor
  • Tyler, TX
National Provider Identifier
1003876830
Registry record updated Nov 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2859 Issued in TX
Legal business name
HEMBREE CHIROPRACTIC PA
Practice address
1904 West Grande Blvd
Tyler, TX 75703-4406
Phone
(903) 561-0086
Fax
(903) 561-2576
NPI assigned
Mar 24, 2006
Last updated
Nov 3, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2011

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

Authorized official

Name
Dr. Mark Hembree, DCNPI 1003887548
Title
President
Phone
(903) 561-0086

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 2859 TX Primary

Addresses

Primary practice location

1904 West Grande Blvd
Tyler, TX 75703-4406

Mailing address

1904 West Grande Blvd
Tyler, TX 75703-4406
Phone (903) 561-0086

Other identifiers 2

IdentifierTypeStateIssuer
0057MDOtherTXBLUE CROSS GROUP ID
173052501MedicaidTX

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050209000841 TX Part B Supplier - Clinic/Group Practice 7618928326 Receives reassigned benefits from 5 practitioners
Practice locations: Tyler, TX

National Provider Directory

National Provider Directory

Locations

212 Grande Blvd
Ste B220
Tyler, TX 75703
Phone (903) 561-0086

2004 W Grande Blvd
Tyler, TX 75703
Phone (903) 561-0086

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320278400000",
    "number": "1003876830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1904 WEST GRANDE BLVD",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757034406",
            "telephone_number": "903-561-0086",
            "fax_number": "903-561-2576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1904 WEST GRANDE BLVD",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757034406",
            "telephone_number": "903-561-0086",
            "fax_number": "903-561-2576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEMBREE CHIROPRACTIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-24",
        "last_updated": "2011-11-03",
        "status": "A",
        "authorized_official_last_name": "HEMBREE",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "903-561-0086",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "2859",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS GROUP ID",
            "identifier": "0057MD",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "173052501",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2011; 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.