Organization Active NPI

Comprehensive Chiropractic PA

  • Medical Specialty Clinic/Center
  • Granbury, TX
National Provider Identifier
1215055058
Registry record updated May 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
10149 Issued in TX
Legal business name
COMPREHENSIVE CHIROPRACTIC PA
Practice address
1321 Waters Edge Dr Ste 1003
Granbury, TX 76048-1233
Phone
(817) 573-0500
Fax
(817) 573-0501
NPI assigned
Mar 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 16, 2011

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

Authorized official

Name
Dr. Kenneth Paul Brassie, D.C.NPI 1447337613
Title
Owner
Phone
(817) 573-0500

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X 10149 TX Primary

Addresses

Primary practice location

1321 Waters Edge Dr Ste 1003
Granbury, TX 76048-1233

Mailing address

1321 Waters Edge Dr
Ste 1003
Granbury, TX 76048-1232
Phone (817) 573-0500

Other identifiers 4

IdentifierTypeStateIssuer
628577OtherTXPHCS
0067MYOtherTXBCBS GROUP
00846ZOtherTXMEDICARE GROUP
8U4210OtherTXBCBS INDIVIDUAL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051220000808 TX Part B Supplier - Clinic/Group Practice 8426070368 Receives reassigned benefits from 1 practitioner
Practice locations: Granbury, TX

National Provider Directory

National Provider Directory

Locations

1321 Waters Edge Dr
#100
Granbury, TX 76048

1030 E Highway 377
Ste 114
Granbury, TX 76048
Phone (817) 573-0500

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1305504000000",
    "number": "1215055058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1321 WATERS EDGE DR",
            "address_2": "STE 1003",
            "city": "GRANBURY",
            "state": "TX",
            "postal_code": "760481232",
            "telephone_number": "817-573-0500",
            "fax_number": "817-573-0501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1321 WATERS EDGE DR STE 1003",
            "city": "GRANBURY",
            "state": "TX",
            "postal_code": "760481233",
            "telephone_number": "817-573-0500",
            "fax_number": "817-573-0501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPREHENSIVE CHIROPRACTIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-27",
        "last_updated": "2011-05-16",
        "status": "A",
        "authorized_official_last_name": "BRASSIE",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-573-0500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "TX",
            "license": "10149",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHCS",
            "identifier": "628577",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP",
            "identifier": "0067MY",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "00846Z",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS INDIVIDUAL",
            "identifier": "8U4210",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Granbury, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.