Individual provider Active NPI

Joyce Daniela Heredia, DC

  • Chiropractor
  • Fort Worth, TX
National Provider Identifier
1265245609
Registry record updated Jan 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
13059 Issued in TX
Practice address
3017 E Lancaster Ave
Fort Worth, TX 76103-2925
Phone
(817) 413-0080
NPI assigned
Jan 29, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 13059 TX Primary

Addresses

Primary practice location

3017 E Lancaster Ave
Fort Worth, TX 76103-2925

Mailing address

3100 Rodeo St
Fort Worth, TX 76119-4722
Phone (817) 528-7528

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
13059TXMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1738108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738108800000",
    "number": "1265245609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 RODEO ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761194722",
            "telephone_number": "817-528-7528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3017 E LANCASTER AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761032925",
            "telephone_number": "817-413-0080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEREDIA",
        "first_name": "JOYCE",
        "middle_name": "DANIELA",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-01-29",
        "last_updated": "2025-01-29",
        "certification_date": "2025-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "13059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2025; 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.