Individual provider Active NPI

Presten Earl Witherspoon, D.C.

  • Chiropractor
  • Mansfield, TX
National Provider Identifier
1356441075
Registry record updated Dec 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
10252 Issued in TX
Practice address
701 E Debbie LN Ste 113
Mansfield, TX 76063-3346
Phone
(817) 592-3664
Fax
(817) 592-3904
NPI assigned
Sep 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3769 OR
Chiropractor 111N00000X 10252 TX Primary

Addresses

Primary practice location

701 E Debbie LN Ste 113
Mansfield, TX 76063-3346

Mailing address

PO Box 1121
Midlothian, TX 76065-1121
Phone (469) 297-8053

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121210000236 TX Practitioner - Chiropractic 5092858118 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
Group practices
Palmercare Chiropractic Mansfield LLCGroup PAC ID 5799159430, 2 clinicians

Practice addresses (Care Compare)

701 E Debbie LN
Suite 113
Mansfield, TX 76063-3346
Phone (817) 592-3664

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10252TXMDProfessional Counselor
3769ORMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Palmercare Chiropractic Mansfield LLC Chiropractor CurrentSince Oct 17, 2023 Accepting new patients
Health Touch LLC Chiropractor PastSince Jan 1, 2003 Accepting new patients

Locations

701 E Debbie Ln
Ste 113
Mansfield, TX 76063
Phone (703) 421-2990

Organizations & group practices 2

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": "1158969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701648000000",
    "number": "1356441075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1121",
            "city": "MIDLOTHIAN",
            "state": "TX",
            "postal_code": "760651121",
            "telephone_number": "469-297-8053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 E DEBBIE LN STE 113",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760633346",
            "telephone_number": "817-592-3664",
            "fax_number": "817-592-3904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITHERSPOON",
        "first_name": "PRESTEN",
        "middle_name": "EARL",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-23",
        "last_updated": "2023-12-04",
        "certification_date": "2023-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "3769",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "10252",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mansfield, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2023; 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.