Individual provider Active NPI

John R Fazzio, DC DACNB

  • Chiropractor
  • Rosenberg, TX
National Provider Identifier
1184717340
Registry record updated Dec 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
6669 Issued in TX
Practice address
5101 Ave H
Suite 25
Rosenberg, TX 77471
Phone
(281) 342-4155
Fax
(281) 342-5132
NPI assigned
Oct 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 6669 TX Primary

Addresses

Primary practice location

5101 Ave H
Suite 25
Rosenberg, TX 77471

Mailing address

5101 Ave H
Suite 25
Rosenberg, TX 77471
Phone (281) 342-4155

Other identifiers 1

IdentifierTypeStateIssuer
8F9255OtherTXMEDICARE PROVIDER NUMBER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081111000209 TX Practitioner - Chiropractic 7719046424 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

323 Fowlkes St
Sealy, TX 77474-2336
Phone (979) 885-7484

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Chiro-Plus Rehabilitation Clinic Inc Chiropractor CurrentSince Aug 11, 2008 Accepting new patients
Downs and Lowman Chiropractic Clinic, Inc. Chiropractor PastSince Aug 11, 2008 Accepting new patients

Locations

5101 Avenue H
Ste 25
Rosenberg, TX 77471
Phone (281) 342-4155

323 Fowlkes St
Sealy, TX 77474
Phone (979) 885-7484

Organizations & group practices 2

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": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228348800000",
    "number": "1184717340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5101 AVE H",
            "address_2": "SUITE 25",
            "city": "ROSENBERG",
            "state": "TX",
            "postal_code": "77471",
            "telephone_number": "281-342-4155",
            "fax_number": "281-342-5132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5101 AVE H",
            "address_2": "SUITE 25",
            "city": "ROSENBERG",
            "state": "TX",
            "postal_code": "77471",
            "telephone_number": "281-342-4155",
            "fax_number": "281-342-5132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAZZIO",
        "first_name": "JOHN",
        "middle_name": "R",
        "credential": "DC DACNB",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2008-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "6669",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PROVIDER NUMBER",
            "identifier": "8F9255",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rosenberg, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2008; 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.