Individual provider Active NPI

Korey Allen Rose, D.C.

  • Chiropractor
  • New Braunfels, TX
National Provider Identifier
1033523139
Registry record updated Jun 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
12655 Issued in TX
Practice address
395 Landa St
New Braunfels, TX 78130-5407
Phone
(830) 629-3101
Fax
(830) 626-8245
NPI assigned
Jun 17, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 12655 TX Primary

Addresses

Primary practice location

395 Landa St
New Braunfels, TX 78130-5407

Mailing address

395 Landa St
New Braunfels, TX 78130-5407
Phone (830) 629-3101

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141124000612 TX Practitioner - Chiropractic 7719209055 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2014
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

368 N Union Ave
New Braunfels, TX 78130-4452
Phone (830) 629-3101

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12655TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Empdc, Inc Chiropractor PastSince Jun 16, 2014 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": "1402963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402963200000",
    "number": "1033523139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "395 LANDA ST",
            "city": "NEW BRAUNFELS",
            "state": "TX",
            "postal_code": "781305407",
            "telephone_number": "830-629-3101",
            "fax_number": "830-626-8245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "395 LANDA ST",
            "city": "NEW BRAUNFELS",
            "state": "TX",
            "postal_code": "781305407",
            "telephone_number": "830-629-3101",
            "fax_number": "830-626-8245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "KOREY",
        "middle_name": "ALLEN",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-17",
        "last_updated": "2014-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "12655",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Braunfels, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.