Organization Active NPI

Perriton Chiropractic LLC

  • Chiropractor
  • Prosper, TX
National Provider Identifier
1215302500
Registry record updated Feb 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
12257 Issued in TX
Legal business name
PERRITON CHIROPRACTIC LLC
Practice address
101 E Broadway St
Prosper, TX 75078-2934
Phone
(972) 347-4138
Fax
(972) 347-3866
NPI assigned
Dec 11, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2026

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

Authorized official

Name
Rebecca Gidleygonzalez
Title
Credentialing Manager
Phone
(817) 941-0209

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 12257 TX Primary

Addresses

Primary practice location

101 E Broadway St
Prosper, TX 75078-2934

Mailing address

101 E Broadway St
Prosper, TX 75078-2934
Phone (972) 347-4138

Other names 1

  • Prosper Chiropractic and Wellness Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210210001244 TX Part B Supplier - Clinic/Group Practice 6305251000 Receives reassigned benefits from 2 practitioners
Practice locations: Prosper, TX

National Provider Directory

National Provider Directory

Locations

101 E Broadway St
Prosper, TX 75078
Phone (972) 347-4138

221 N Preston Rd
Ste D
Prosper, TX 75078
Phone (817) 941-0209

Practitioners & affiliated clinicians

Practitioners 4

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": "1449792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769990400000",
    "number": "1215302500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 E BROADWAY ST",
            "city": "PROSPER",
            "state": "TX",
            "postal_code": "750782934",
            "telephone_number": "972-347-4138",
            "fax_number": "972-347-3866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 E BROADWAY ST",
            "city": "PROSPER",
            "state": "TX",
            "postal_code": "750782934",
            "telephone_number": "972-347-4138",
            "fax_number": "972-347-3866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERRITON CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-11",
        "last_updated": "2026-02-02",
        "certification_date": "2026-02-02",
        "status": "A",
        "authorized_official_last_name": "GIDLEYGONZALEZ",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "817-941-0209"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "12257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Prosper Chiropractic and Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Prosper Chiropractic and Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Prosper, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2026; 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.