Individual provider Active NPI

Stephanie Ann Bartuch, D.C.

  • Chiropractor
  • Trophy Club, TX
National Provider Identifier
1104851682
Registry record updated Mar 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
13894 Issued in TX
Practice address
501 Trophy Lake Dr
Trophy Club, TX 76262-5222
Phone
(817) 725-8889
NPI assigned
Jul 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 13894 TX Primary

Addresses

Primary practice location

501 Trophy Lake Dr
Trophy Club, TX 76262-5222

Mailing address

1804 Firenze St
Keller, TX 76262-8036
Phone (817) 725-8889

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

State licenses

LicenseStateTypeSpecialty
13894TXMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Plainfield Chiropractic and Rehabilitation, LTD Chiropractor CurrentSince Jul 18, 2016 Accepting new patients
Metroplex Spinal & Sports Chiropractic, LTD. Chiropractor CurrentSince Mar 22, 2020 Accepting new patients

Locations

13520 S Route 59
Ste 100
Plainfield, IL 60544
Phone (615) 871-9000

501 Trophy Lake Dr
Trophy Club, TX 76262
Phone (817) 725-8889

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": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584057600000",
    "number": "1104851682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1804 FIRENZE ST",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "762628036",
            "telephone_number": "817-725-8889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 TROPHY LAKE DR",
            "city": "TROPHY CLUB",
            "state": "TX",
            "postal_code": "762625222",
            "telephone_number": "817-725-8889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARTUCH",
        "first_name": "STEPHANIE",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-12",
        "last_updated": "2020-03-13",
        "certification_date": "2020-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "13894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Trophy Club, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2020; 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.