Individual provider Active NPI

Kevin E Witt, D.C.

  • Chiropractor
  • Euless, TX
National Provider Identifier
1336164367
Registry record updated Jul 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC4385 Issued in TX
Practice address
503 W Euless Blvd
Euless, TX 76040-4426
Phone
(817) 267-8850
Fax
(817) 545-9748
NPI assigned
Jul 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC4385 TX Primary

Addresses

Primary practice location

503 W Euless Blvd
Euless, TX 76040-4426

Mailing address

503 W Euless Blvd
Euless, TX 76040-4426
Phone (817) 267-8850

Other identifiers 1

IdentifierTypeStateIssuer
00A44WOtherTXMEDICARE BLUE CROSS BLUE SHIELD

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC4385TXMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Seastrunk Chiropractic LLC Chiropractor CurrentSince Sep 20, 2022 Accepting new patients

Locations

503 W Euless Blvd
Euless, TX 76040
Phone (817) 267-8850

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": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657584000000",
    "number": "1336164367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "503 W EULESS BLVD",
            "city": "EULESS",
            "state": "TX",
            "postal_code": "760404426",
            "telephone_number": "817-267-8850",
            "fax_number": "817-545-9748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 W EULESS BLVD",
            "city": "EULESS",
            "state": "TX",
            "postal_code": "760404426",
            "telephone_number": "817-267-8850",
            "fax_number": "817-545-9748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITT",
        "first_name": "KEVIN",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2022-07-12",
        "certification_date": "2022-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "DC4385",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE BLUE CROSS BLUE SHIELD",
            "identifier": "00A44W",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Euless, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2022; 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.