Individual provider Active NPI

Chandler James Pruitt, DC

  • Chiropractor
  • Denton, TX
National Provider Identifier
1184084717
Registry record updated Mar 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
13161 Issued in TX
Practice address
638 Londonderry LN
Denton, TX 76205-5379
Phone
(940) 565-8118
Fax
(940) 387-3070
NPI assigned
Feb 24, 2016
Last updated
Mar 31, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 31, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 13161 TX Primary

Addresses

Primary practice location

638 Londonderry LN
Denton, TX 76205-5379

Mailing address

638 Londonderry LN
Denton, TX 76205-5379
Phone (940) 565-8118

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160614000327 TX Practitioner - Chiropractic 4183915606 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
BC Chiropractic PAGroup PAC ID 9537107610, 3 clinicians

Practice addresses (Care Compare)

3201 Teasley LN
Suite 102
Denton, TX 76210-8301
Phone (940) 565-8118

638 Londonderry LN
Denton, TX 76205-5379

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
BC Chiropractic PA Chiropractor CurrentSince Aug 12, 2019 Accepting new patients
Chiropractic & Sports Clinic Chiropractor CurrentSince Apr 13, 2016 Accepting new patients
Cleburne Integrated Wellness PA PastSince May 23, 2017 Accepting new patients

Locations

1001 SW Wilshire Blvd
Ste D
Burleson, TX 76028
Phone (817) 447-1414

1649 W Henderson St
Ste A
Cleburne, TX 76033
Phone (817) 641-4042

821 N Nolan River Rd
Cleburne, TX 76033
Phone (817) 556-2000

3201 Teasley Ln
Ste 102
Denton, TX 76210
Phone (940) 565-1510

638 Londonderry Ln
Denton, TX 76205
Phone (940) 565-8118

4747 S Hulen St
Ste 101
Ft Worth, TX 76132
Phone (682) 708-2225

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1456272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585612800000",
    "number": "1184084717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "638 LONDONDERRY LN",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762055379",
            "telephone_number": "940-565-8118",
            "fax_number": "940-387-3070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "638 LONDONDERRY LN",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762055379",
            "telephone_number": "940-565-8118",
            "fax_number": "940-387-3070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRUITT",
        "first_name": "CHANDLER",
        "middle_name": "JAMES",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-02-24",
        "last_updated": "2020-03-31",
        "certification_date": "2020-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "13161",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denton, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2020; 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.