Individual provider Active NPI

Brian Keith Clemons, D.C.

  • Chiropractor
  • Houston, TX
National Provider Identifier
1013063734
Registry record updated Dec 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
6204 Issued in TX
Practice address
930 Main St
Suite T-275
Houston, TX 77002-6201
Phone
(713) 739-1136
Fax
(713) 739-8200
NPI assigned
Jan 26, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 3, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 6204 TX Primary

Addresses

Primary practice location

930 Main St
Suite T-275
Houston, TX 77002-6201

Mailing address

930 Main St
Suite T-275
Houston, TX 77002-6201
Phone (713) 739-1136

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090423000081 TX Practitioner - ChiropracticPractitioner - Physical Medicine and Rehabilitation 4082762497 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
ChiropracticAlso: Physical Medicine and Rehabilitation
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

930 Main St
Suite T275
Houston, TX 77002-6232
Phone (713) 739-1136

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6204TXMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Chiropractic Center of Houston, P.C. Chiropractor CurrentSince Feb 27, 1997 Accepting new patients

Locations

930 Main St
Ste T275
Houston, TX 77002
Phone (713) 739-1136

Networks

  • TX HMO D-SNP
  • TX HMO
  • NM HMO C-SNP

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354492800000",
    "number": "1013063734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "930 MAIN ST",
            "address_2": "SUITE T-275",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770026201",
            "telephone_number": "713-739-1136",
            "fax_number": "713-739-1137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 MAIN ST",
            "address_2": "SUITE T-275",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770026201",
            "telephone_number": "713-739-1136",
            "fax_number": "713-739-8200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEMONS",
        "first_name": "BRIAN",
        "middle_name": "KEITH",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-26",
        "last_updated": "2012-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "6204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.