Individual provider Active NPI

Michael Richard Prochaska, DC

  • Chiropractor
  • Allen, TX
National Provider Identifier
1376295840
Registry record updated Jan 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
15045 Issued in TX
Practice address
610 S Watters Rd Ste 100
Allen, TX 75013-5008
Phone
(469) 414-0659
NPI assigned
Jan 25, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 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 15045 TX Primary

Addresses

Primary practice location

610 S Watters Rd Ste 100
Allen, TX 75013-5008

Mailing address

4800 Keller Springs Rd Apt 1482
Addison, TX 75001-6542
Phone (330) 840-9967

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
15045TXMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1643068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643068800000",
    "number": "1376295840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 KELLER SPRINGS RD APT 1482",
            "city": "ADDISON",
            "state": "TX",
            "postal_code": "750016542",
            "telephone_number": "330-840-9967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 S WATTERS RD STE 100",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750135008",
            "telephone_number": "469-414-0659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROCHASKA",
        "first_name": "MICHAEL",
        "middle_name": "RICHARD",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-01-25",
        "last_updated": "2022-01-25",
        "certification_date": "2022-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "15045",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allen, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 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.