Individual provider Active NPI

Brad L Walker, D.C.

  • Chiropractor
  • Lumberton, TX
National Provider Identifier
1376621649
Registry record updated Sep 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
8191 Issued in TX
Practice address
837 N Main St Ste 110
Lumberton, TX 77657-7358
Phone
(409) 755-7246
NPI assigned
Nov 2, 2006
Last updated
Sep 14, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 14, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 8191 TX Primary

Addresses

Primary practice location

837 N Main St Ste 110
Lumberton, TX 77657-7358

Mailing address

PO Box 8023
Lumberton, TX 77657-0023
Phone (409) 755-7246

Other identifiers 3

IdentifierTypeStateIssuer
5247721OtherTXAETNA
8B0950OtherTXBCBS
42076300OtherTXCIGNA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100823001046 TX Practitioner - Chiropractic 4284758574 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1998
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

837 N Main St
SPC 110
Lumberton, TX 77657-1018
Phone (409) 755-7246

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8191TXMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
New Territory Health Center, PC Chiropractor PastSince May 23, 2010 Accepting new patients
East Texas Chiropractic of Jasper, PA Chiropractor PastSince Dec 13, 2009 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284422400000",
    "number": "1376621649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8023",
            "city": "LUMBERTON",
            "state": "TX",
            "postal_code": "776570023",
            "telephone_number": "409-755-7246",
            "fax_number": "409-755-7629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "837 N MAIN ST STE 110",
            "city": "LUMBERTON",
            "state": "TX",
            "postal_code": "776577358",
            "telephone_number": "409-755-7246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "BRAD",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-02",
        "last_updated": "2010-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "8191",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5247721",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8B0950",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "42076300",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lumberton, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2010; 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.