Individual provider Active NPI

Shirley Ann Mata, D.C

  • Occupational Health Chiropractor
  • El Paso, TX
National Provider Identifier
1194879312
Registry record updated Jul 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Health ChiropractorTaxonomy code 111NX0100X
License
DC6402 Issued in TX
Practice address
10600 Montwood Dr
Suite 113
El Paso, TX 79935-2700
Phone
(915) 252-9832
Fax
(915) 595-6953
NPI assigned
Jan 23, 2007
Last updated
Jul 16, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Health Chiropractor 111NX0100X DC6402 TX Primary

Addresses

Primary practice location

10600 Montwood Dr
Suite 113
El Paso, TX 79935-2700

Mailing address

PO Box 962037
El Paso, TX 79996-2037
Phone (915) 252-9832

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

State licenses

LicenseStateTypeSpecialty
DC6402TXMDOccupational Health Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Desert Sun Chiropractic PLLC PastSince Apr 7, 2006 Accepting new patients
Desert Sun Chiropractic East LLC PastSince Feb 9, 2020 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": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405468800000",
    "number": "1194879312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 962037",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799962037",
            "telephone_number": "915-252-9832",
            "fax_number": "915-594-8972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10600 MONTWOOD DR",
            "address_2": "SUITE 113",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799352700",
            "telephone_number": "915-252-9832",
            "fax_number": "915-595-6953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATA",
        "first_name": "SHIRLEY",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "D.C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-23",
        "last_updated": "2014-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NX0100X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Occupational Health",
            "state": "TX",
            "license": "DC6402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2014; 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.