Individual provider Active NPI

Jenna Denise Beck, D.C., B.S.

  • Chiropractor
  • Roanoke, TX
National Provider Identifier
1194157099
Registry record updated Apr 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
12402 Issued in TX
Practice address
100 Country View Dr Ste 300
Roanoke, TX 76262-2054
Phone
(682) 237-2322
NPI assigned
Aug 1, 2013
Last updated
Apr 30, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 30, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 12402 TX Primary

Addresses

Primary practice location

100 Country View Dr Ste 300
Roanoke, TX 76262-2054

Mailing address

100 Country View Dr Ste 300
Roanoke, TX 76262-2054
Phone (682) 237-2322

Other names 1

  • Dr. Jenna Denise Schulz Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor of Science

State licenses

LicenseStateTypeSpecialty
12402TXMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Impact Medical and Chiropractic, PLLC PastSince Mar 5, 2016 Accepting new patients

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, 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": "1375315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525046400000",
    "number": "1194157099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 COUNTRY VIEW DR STE 300",
            "city": "ROANOKE",
            "state": "TX",
            "postal_code": "762622054",
            "telephone_number": "682-237-2322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 COUNTRY VIEW DR STE 300",
            "city": "ROANOKE",
            "state": "TX",
            "postal_code": "762622054",
            "telephone_number": "682-237-2322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BECK",
        "first_name": "JENNA",
        "middle_name": "DENISE",
        "name_prefix": "Dr.",
        "credential": "D.C., B.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-01",
        "last_updated": "2018-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "12402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNA",
            "last_name": "SCHULZ",
            "middle_name": "DENISE",
            "prefix": "DR.",
            "credential": "DC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Roanoke, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.