Active NPI
Marentha S Coffee, DC
- Chiropractor
- Dallas, TX
National Provider Identifier
1114023934
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 9622
- Practice address
- 14330 Midway Rd
Suite 116
Dallas, TX 75244-3522 - Phone
- (469) 547-1173
- Fax
- (469) 629-5007
- NPI assigned
- Sep 16, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 9622 | TX | Primary |
Addresses
Primary practice location
14330 Midway Rd
Suite 116
Dallas, TX 75244-3522
Mailing address
14330 Midway Rd
Suite 116
Dallas, TX 75244-3522
Phone (469) 547-1173
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8P1441 | Other | TX | BCBS |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 9622 | TX | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158364800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1338249600000",
"number": "1114023934",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14330 MIDWAY RD",
"address_2": "SUITE 116",
"city": "DALLAS",
"state": "TX",
"postal_code": "752443522",
"telephone_number": "469-547-1173",
"fax_number": "469-629-5007"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14330 MIDWAY RD",
"address_2": "SUITE 116",
"city": "DALLAS",
"state": "TX",
"postal_code": "752443522",
"telephone_number": "469-547-1173",
"fax_number": "469-629-5007"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COFFEE",
"first_name": "MARENTHA",
"middle_name": "S",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-16",
"last_updated": "2012-05-29",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "TX",
"license": "9622",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "8P1441",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.