Individual provider Active NPI

Charles B Keith, D.C.

  • Chiropractor
  • Rockwall, TX
National Provider Identifier
1265472369
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4465 Issued in TX
Practice address
316 S Goliad St
Suite 111
Rockwall, TX 75087-3760
Phone
(972) 771-9448
Fax
(972) 771-8393
NPI assigned
Jun 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4465 TX Primary

Addresses

Primary practice location

316 S Goliad St
Suite 111
Rockwall, TX 75087-3760

Mailing address

316 S Goliad St
Suite 111
Rockwall, TX 75087-3760
Phone (972) 771-9448

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120313000502 TX Practitioner - Chiropractic 3870752769 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

316 S Goliad St
Suite 111
Rockwall, TX 75087-3761
Phone (972) 771-9448

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4465TXMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Family Care Chiropractic Clinic, P.C. Chiropractor CurrentSince Dec 15, 2011 Accepting new patients

Locations

316 S Goliad St
Ste 111
Rockwall, TX 75087
Phone (972) 771-9448

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1265472369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "316 S GOLIAD ST",
            "address_2": "SUITE 111",
            "city": "ROCKWALL",
            "state": "TX",
            "postal_code": "750873760",
            "telephone_number": "972-771-9448",
            "fax_number": "972-771-8393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 S GOLIAD ST",
            "address_2": "SUITE 111",
            "city": "ROCKWALL",
            "state": "TX",
            "postal_code": "750873760",
            "telephone_number": "972-771-9448",
            "fax_number": "972-771-8393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEITH",
        "first_name": "CHARLES",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "4465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockwall, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.