Organization Active NPI

Isdale Chiropractic Clinic

  • Chiropractor
  • Killeen, TX
National Provider Identifier
1073621223
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2385 Issued in TX
Legal business name
ISDALE CHIROPRACTIC CLINIC
Practice address
1201 Winkler Ave
Killeen, TX 76542-6108
Phone
(254) 699-4004
Fax
(254) 699-4056
NPI assigned
Aug 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Scott Edward Isdale, D.C.NPI 1073535068
Title
Doctor / Owner
Phone
(254) 699-4004

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 2385 TX Primary

Addresses

Primary practice location

1201 Winkler Ave
Killeen, TX 76542-6108

Mailing address

1201 Winkler Ave
Killeen, TX 76542-6108
Phone (254) 699-4004

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040317001393 TX Part B Supplier - Clinic/Group Practice 1052201688 Receives reassigned benefits from 4 practitioners
Practice locations: Killeen, TX

National Provider Directory

National Provider Directory

Locations

1201 Winkler Ave
Killeen, TX 76542
Phone (254) 699-4004

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1073621223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 WINKLER AVE",
            "city": "KILLEEN",
            "state": "TX",
            "postal_code": "765426108",
            "telephone_number": "254-699-4004",
            "fax_number": "254-699-4056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 WINKLER AVE",
            "city": "KILLEEN",
            "state": "TX",
            "postal_code": "765426108",
            "telephone_number": "254-699-4004",
            "fax_number": "254-699-4056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ISDALE CHIROPRACTIC CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ISDALE",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "DOCTOR / OWNER",
        "authorized_official_telephone_number": "254-699-4004",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "2385",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Killeen, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.