Active NPI
Shedrack Raines
- Chiropractor
- Dallas, TX
National Provider Identifier
1386029551
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 13004
- Practice address
- 211 E Clarendon Dr
Dallas, TX 75203-2914 - Phone
- (817) 629-1027
- NPI assigned
- Jul 29, 2015
- Last updated
- Jul 29, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 13004 | TX | Primary |
Addresses
Primary practice location
211 E Clarendon Dr
Dallas, TX 75203-2914
Mailing address
PO Box 2210
Euless, TX 76039-7021
Phone (817) 629-1027
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13004 | TX | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Health & Spinal Rejuvenation Clinic LLC | Chiropractor | Current | Accepting new patients |
Locations
1233 E Pleasant Run Rd
#B
Desoto, TX 75115
Phone (469) 567-8242
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Chiropractor
- Desoto, TX
- NPI 1336601947
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1438128000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1438128000000",
"number": "1386029551",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2210",
"city": "EULESS",
"state": "TX",
"postal_code": "760397021",
"telephone_number": "817-629-1027"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "211 E CLARENDON DR",
"city": "DALLAS",
"state": "TX",
"postal_code": "752032914",
"telephone_number": "817-629-1027"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAINES",
"first_name": "SHEDRACK",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-07-29",
"last_updated": "2015-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "TX",
"license": "13004",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.