Individual provider Active NPI

Glenn Lee Cavett, D.C.

  • Chiropractor
  • Wichita Falls, TX
National Provider Identifier
1124069117
Registry record updated Apr 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4944 Issued in TX
Practice address
4111 Call Field Rd Ste 300
Wichita Falls, TX 76308-2542
Phone
(940) 696-2211
Fax
(940) 696-5641
NPI assigned
Jun 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4944 TX Primary

Addresses

Primary practice location

4111 Call Field Rd Ste 300
Wichita Falls, TX 76308-2542

Mailing address

4111 Call Field Rd
Suite 300
Wichita Falls, TX 76308-2516
Phone (940) 696-2211

Other identifiers 1

IdentifierTypeStateIssuer
P081M0034MedicaidTX

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110103000824 TX Practitioner - Chiropractic 7517969546 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4111 Call Field Rd
Suite 300
Wichita Falls, TX 76308-2542
Phone (940) 696-2211

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4944TXMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Brown Cavett Back and Neck Chiropractic Chiropractor CurrentSince May 30, 1991 Accepting new patients

Locations

4111 Call Field Rd
Ste 300
Wichita Falls, TX 76308
Phone (940) 696-2211

Organizations & group practices 1

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": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428969600000",
    "number": "1124069117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4111 CALL FIELD RD",
            "address_2": "SUITE 300",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763082516",
            "telephone_number": "940-696-2211",
            "fax_number": "940-696-5641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4111 CALL FIELD RD STE 300",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763082542",
            "telephone_number": "940-696-2211",
            "fax_number": "940-696-5641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAVETT",
        "first_name": "GLENN",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-09",
        "last_updated": "2015-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "4944",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "P081M0034",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita Falls, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.