Organization Active NPI

Ondracek Chiropractic

  • Chiropractor
  • Conroe, TX
National Provider Identifier
1174700181
Registry record updated Sep 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5282 Issued in TX
Legal business name
ONDRACEK CHIROPRACTIC
Practice address
611 W Davis St
Conroe, TX 77301-2702
Phone
(936) 760-3332
Fax
(936) 760-3223
NPI assigned
Jan 22, 2008
Last updated
Sep 3, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2009

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

Authorized official

Name
Dr. Milton Ondracek, D.C.NPI 1962586008
Title
Director
Phone
(936) 760-3332

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 5282 TX Primary

Addresses

Primary practice location

611 W Davis St
Conroe, TX 77301-2702

Mailing address

611 W Davis St
Conroe, TX 77301-2702

Other identifiers 3

IdentifierTypeStateIssuer
088410801MedicaidTX
Y02656OtherUPIN
603268OtherUTMEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091105000349 TX Part B Supplier - Clinic/Group Practice 8820136278 Receives reassigned benefits from 2 practitioners
Practice locations: Conroe, TX

National Provider Directory

National Provider Directory

Locations

611 W Davis St
Conroe, TX 77301
Phone (936) 760-3332

Practitioners & affiliated clinicians

Practitioners 2

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": "1200960000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1251936000000",
    "number": "1174700181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 W DAVIS ST",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773012702",
            "fax_number": "936-760-3223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 W DAVIS ST",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773012702",
            "telephone_number": "936-760-3332",
            "fax_number": "936-760-3223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ONDRACEK CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-22",
        "last_updated": "2009-09-03",
        "status": "A",
        "authorized_official_last_name": "ONDRACEK",
        "authorized_official_first_name": "MILTON",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "936-760-3332",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "5282",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "088410801",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPIN",
            "identifier": "Y02656",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "603268",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Conroe, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2009; 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.