Individual provider Active NPI

Samuel Adam Blankenburg, DC

  • Chiropractor
  • Irving, TX
National Provider Identifier
1114719226
Registry record updated May 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
16475 Issued in TX
Practice address
100 E Royal LN Ste 125
Irving, TX 75039-4215
Phone
(214) 920-9111
NPI assigned
May 22, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 16475 TX Primary

Addresses

Primary practice location

100 E Royal LN Ste 125
Irving, TX 75039-4215

Mailing address

100 E Royal LN Ste 125
Irving, TX 75039-4215

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
16475TXMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1747872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747872000000",
    "number": "1114719226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E ROYAL LN STE 125",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750394215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E ROYAL LN STE 125",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750394215",
            "telephone_number": "214-920-9111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANKENBURG",
        "first_name": "SAMUEL",
        "middle_name": "ADAM",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-05-22",
        "last_updated": "2025-05-22",
        "certification_date": "2025-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "16475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irving, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2025; 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.