NPIMap

Organization Active NPI

Sandstone Chiropratic, P.a.

  • Chiropractor
  • Montgomery, TX
National Provider Identifier
1154585636
Registry record updated Jul 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
8344 Issued in TX
Legal business name
SANDSTONE CHIROPRATIC, P.A.
Practice address
123 Blue Heron Dr Ste 104
Montgomery, TX 77316-3192
Phone
(936) 582-0404
Fax
(936) 582-0410
NPI assigned
Jul 15, 2008
Last updated
Jul 15, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2008

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

Authorized official

Name
Dr. Tony W Deramus, DCNPI 1750494985
Title
President
Phone
(936) 582-0404

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
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 8344 TX Primary

Addresses

Primary practice location

123 Blue Heron Dr Ste 104
Montgomery, TX 77316-3192

Mailing address

123 Blue Heron Dr Ste 104
Montgomery, TX 77316-3192
Phone (936) 582-0404

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090210000206 TX Part B Supplier - Clinic/Group Practice 0547325466 Receives reassigned benefits from 4 practitioners
Practice locations: Montgomery, TX

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

125 Blue Heron Dr
#B
Montgomery, TX 77316
Phone (936) 582-0404

Interoperability endpoints

  • Direct secure messaging: doc@ssc0001.direct.chirotouch.md

Practitioners & affiliated clinicians

Practitioners 12

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": "1216080000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216080000000",
    "number": "1154585636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 BLUE HERON DR STE 104",
            "city": "MONTGOMERY",
            "state": "TX",
            "postal_code": "773163192",
            "telephone_number": "936-582-0404",
            "fax_number": "936-582-0410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 BLUE HERON DR STE 104",
            "city": "MONTGOMERY",
            "state": "TX",
            "postal_code": "773163192",
            "telephone_number": "936-582-0404",
            "fax_number": "936-582-0410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANDSTONE CHIROPRATIC, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-15",
        "last_updated": "2008-07-15",
        "status": "A",
        "authorized_official_last_name": "DERAMUS",
        "authorized_official_first_name": "TONY",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "936-582-0404",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "8344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2008; 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.