NPIMap

Individual provider Active NPI

Kevin Stice, D.C.

  • Chiropractor
  • Southlake, TX
National Provider Identifier
1033414685
Registry record updated Jul 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
11657 Issued in TX
Practice address
500 North Carroll Avenue
#100
Southlake, TX 76092-6410
Phone
(817) 488-6495
Fax
(817) 488-6592
NPI assigned
Jan 12, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 13, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 11657 TX Primary

Addresses

Primary practice location

500 North Carroll Avenue
#100
Southlake, TX 76092-6410

Mailing address

1510 Scurry Ste. C
Big Spring, TX 79720
Phone (432) 606-5140

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Psychology Consultants PLLC Past Accepting new patients
Stice Chiropractic & Wellness Center Chiropractor PastSince Nov 28, 2011 Accepting new patients

Organizations & group practices 2

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": "1294790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1499904000000",
    "number": "1033414685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1510 SCURRY STE. C",
            "city": "BIG SPRING",
            "state": "TX",
            "postal_code": "79720",
            "telephone_number": "432-606-5140",
            "fax_number": "432-606-5141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 NORTH CARROLL AVENUE",
            "address_2": "#100",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760926410",
            "telephone_number": "817-488-6495",
            "fax_number": "817-488-6592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STICE",
        "first_name": "KEVIN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-01-12",
        "last_updated": "2017-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "11657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southlake, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.