Organization Active NPI

Plainview Chiropractic PA

  • Chiropractor
  • Plainview, TX
National Provider Identifier
1124538350
Registry record updated Dec 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
12749 Issued in TX
Legal business name
PLAINVIEW CHIROPRACTIC PA
Practice address
4304 Olton Rd
Plainview, TX 79072-5810
Phone
(806) 429-5111
Fax
(806) 429-5131
NPI assigned
Oct 2, 2017
Last updated
Dec 12, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2017

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

Authorized official

Name
Dr. Jared David Chambless, DCNPI 1891198263
Title
Owner
Phone
(806) 429-5111

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
Chiropractor 111N00000X 12749 TX Primary

Addresses

Primary practice location

4304 Olton Rd
Plainview, TX 79072-5810

Mailing address

4304 Olton Rd
Plainview, TX 79072-5810
Phone (806) 429-5111

Other identifiers 1

IdentifierTypeStateIssuer
618402OtherTXMEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171204002081 TX Part B Supplier - Clinic/Group Practice 3870850688 Receives reassigned benefits from 1 practitioner
Practice locations: Plainview, TX

National Provider Directory

National Provider Directory

Locations

4304 Olton Rd
Plainview, TX 79072
Phone (806) 293-5001

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1506902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1513036800000",
    "number": "1124538350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4304 OLTON RD",
            "city": "PLAINVIEW",
            "state": "TX",
            "postal_code": "790725810",
            "telephone_number": "806-429-5111",
            "fax_number": "806-429-5131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4304 OLTON RD",
            "city": "PLAINVIEW",
            "state": "TX",
            "postal_code": "790725810",
            "telephone_number": "806-429-5111",
            "fax_number": "806-429-5131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLAINVIEW CHIROPRACTIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-02",
        "last_updated": "2017-12-12",
        "status": "A",
        "authorized_official_last_name": "CHAMBLESS",
        "authorized_official_first_name": "JARED",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "806-429-5111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "12749",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "618402",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plainview, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2017; 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.