Organization Active NPI

Denison Chiropractic, Inc

  • Chiropractor
  • Denison, TX
National Provider Identifier
1083020713
Registry record updated Jan 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2868 Issued in TX
Legal business name
DENISON CHIROPRACTIC, INC
Practice address
1721 S Austin Ave
Denison, TX 75020-6709
Phone
(903) 463-5151
Fax
(903) 463-6584
NPI assigned
Jul 2, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2024

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

Authorized official

Name
Dr. Dustin Daniel Bergeron, D.C.NPI 1023446648
Title
President
Phone
(903) 463-5151

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 2868 TX Primary

Addresses

Primary practice location

1721 S Austin Ave
Denison, TX 75020-6709

Mailing address

1721 S Austin Ave
Denison, TX 75020-6709
Phone (903) 463-5151

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240501000970 TX Part B Supplier - Clinic/Group Practice 4880918804 Receives reassigned benefits from 1 practitioner
Practice locations: Denison, TX

National Provider Directory

National Provider Directory

Locations

1721 S Austin Ave
Denison, TX 75020
Phone (903) 463-5151

Practitioners & affiliated clinicians

Practitioners 1

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": "1404259200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705363200000",
    "number": "1083020713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1721 S AUSTIN AVE",
            "city": "DENISON",
            "state": "TX",
            "postal_code": "750206709",
            "telephone_number": "903-463-5151",
            "fax_number": "903-463-6584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1721 S AUSTIN AVE",
            "city": "DENISON",
            "state": "TX",
            "postal_code": "750206709",
            "telephone_number": "903-463-5151",
            "fax_number": "903-463-6584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENISON CHIROPRACTIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-02",
        "last_updated": "2024-01-16",
        "certification_date": "2024-01-16",
        "status": "A",
        "authorized_official_last_name": "BERGERON",
        "authorized_official_first_name": "DUSTIN",
        "authorized_official_middle_name": "DANIEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "903-463-5151",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "2868",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denison, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2024; 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.