Individual provider Active NPI

David Allan Cervenka, D.C.

  • Chiropractor
  • Angleton, TX
National Provider Identifier
1194079061
Registry record updated Oct 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
12151 Issued in TX
Practice address
1124 N Velasco St
Suite E
Angleton, TX 77515-3160
Phone
(979) 849-8900
Fax
(979) 849-9995
NPI assigned
Oct 31, 2012
Last updated
Oct 31, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 12151 TX Primary

Addresses

Primary practice location

1124 N Velasco St
Suite E
Angleton, TX 77515-3160

Mailing address

1124 N Velasco St
Suite E
Angleton, TX 77515-3160
Phone (979) 849-8900

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130917000351 TX Practitioner - Chiropractic 8921242785 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1124 N Velasco St E
Angelton Chiro and Rehab
Angleton, TX 77515-3161
Phone (979) 849-8900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12151TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Angleton Chiropractic & Rehab, PLLC Chiropractor CurrentSince Sep 11, 2013 Accepting new patients

Locations

1124 N Velasco St
Ste E
Angleton, TX 77515
Phone (979) 849-8900

Organizations & group practices 1

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": "1351641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351641600000",
    "number": "1194079061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1124 N VELASCO ST",
            "address_2": "SUITE E",
            "city": "ANGLETON",
            "state": "TX",
            "postal_code": "775153160",
            "telephone_number": "979-849-8900",
            "fax_number": "979-849-9995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1124 N VELASCO ST",
            "address_2": "SUITE E",
            "city": "ANGLETON",
            "state": "TX",
            "postal_code": "775153160",
            "telephone_number": "979-849-8900",
            "fax_number": "979-849-9995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CERVENKA",
        "first_name": "DAVID",
        "middle_name": "ALLAN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-10-31",
        "last_updated": "2012-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "12151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Angleton, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2012; 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.