Individual provider Active NPI

Kevin Michael Guerra, DC

  • Chiropractor
  • Lewisville, TX
National Provider Identifier
1215601208
Registry record updated Aug 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
14799 Issued in TX
Practice address
2540 King Arthur Blvd Ste 130
Lewisville, TX 75056-5922
Phone
(972) 899-9737
NPI assigned
Aug 4, 2021
Last updated
Aug 4, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 14799 TX Primary

Addresses

Primary practice location

2540 King Arthur Blvd Ste 130
Lewisville, TX 75056-5922

Mailing address

2540 King Arthur Blvd Ste 130
Lewisville, TX 75056-5922
Phone (972) 899-9737

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address info@atchleycc.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221021000294 TX Practitioner - Chiropractic 3375919087 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14799TXMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Atchley Chiropractic Centers of Prosper LLC Chiropractor CurrentSince Aug 1, 2022 Accepting new patients
DCB Health, Inc PastSince Aug 8, 2021 Accepting new patients

Locations

120 S Preston Rd
Ste 10
Prosper, TX 75078
Phone (972) 346-0066

Organizations & group practices 3

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": "1628035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628035200000",
    "number": "1215601208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2540 KING ARTHUR BLVD STE 130",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "750565922",
            "telephone_number": "972-899-9737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2540 KING ARTHUR BLVD STE 130",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "750565922",
            "telephone_number": "972-899-9737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUERRA",
        "first_name": "KEVIN",
        "middle_name": "MICHAEL",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-04",
        "last_updated": "2021-08-04",
        "certification_date": "2021-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "14799",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@atchleycc.com",
            "affiliation": "N",
            "endpointDescription": "E-Mail",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2540 King Arthur Blvd Ste 130",
            "city": "Lewisville",
            "state": "TX",
            "country_code": "US",
            "postal_code": "750565922",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lewisville, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2021; 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.