Individual provider Active NPI

Gideon Traweek, D.C.

  • Chiropractor
  • Fort Worth, TX
National Provider Identifier
1295966133
Registry record updated Jul 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
10322 Issued in TX
Practice address
3625 Western Center Blvd
Fort Worth, TX 76137-1936
Phone
(817) 498-7333
Fax
(817) 581-2866
NPI assigned
Jul 27, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 10322 TX Primary

Addresses

Primary practice location

3625 Western Center Blvd
Fort Worth, TX 76137-1936

Mailing address

PO Box 121309
Fort Worth, TX 76121-1305
Phone (817) 498-7333

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120302000420 TX Practitioner - Chiropractic 7315106887 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3625 Western Ctr Blvd
Ft Worth, TX 76137-1936
Phone (817) 498-7333

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10322TXMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Fort Worth Health Alliance, LLC Current Accepting new patients
Todd Ruland D C P C Chiropractor PastSince Jan 1, 2012 Accepting new patients

Locations

3625 Western Center Blvd
Ft Worth, TX 76137
Phone (817) 498-7333

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1248652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248652800000",
    "number": "1295966133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 121309",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761211305",
            "telephone_number": "817-498-7333",
            "fax_number": "817-581-2866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3625 WESTERN CENTER BLVD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761371936",
            "telephone_number": "817-498-7333",
            "fax_number": "817-581-2866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAWEEK",
        "first_name": "GIDEON",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-27",
        "last_updated": "2009-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "10322",
            "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 Jul 27, 2009; 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.