Clinton Keith Dacus, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

11063 Issued in TX

Practice address

2771 E Broad St
Ste 211
Mansfield, TX 76063-9157

Phone

(682) 518-6263

Fax

(682) 325-3733

NPI assigned

Jan 29, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Specialty

Chiropractic

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Dacus Chiropractic PLLC

  • Chiropractor
  • Mansfield, TX
  • NPI 1972741775
  Medicare reassignment NPD Authorized official
• SMD Physical Therapy PLLC

  • Physical Therapist
  • Mansfield, TX
  • NPI 1821406125
  NPD (past)

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

{
    "created_epoch": "1233187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401148800000",
    "number": "1386882314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2771 E BROAD ST",
            "address_2": "STE 211",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760639157",
            "telephone_number": "682-518-6263",
            "fax_number": "682-325-3733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2771 E BROAD ST",
            "address_2": "STE 211",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760639157",
            "telephone_number": "682-518-6263",
            "fax_number": "682-325-3733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DACUS",
        "first_name": "CLINTON",
        "middle_name": "KEITH",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-01-29",
        "last_updated": "2014-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "11063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• CVS Pharmacy Inc
• CVS Pharmacy Inc.
• Nicole Leigh Dabbs, M.S. CCC-SLP
• Dac Senior Care Management LLC
• Dacus Chiropractic PLLC
• Shauna Dacus, PT
• Dalamar Services, Inc
• Dales Non Emergency Transportation Inc
• Dallas Oncology Consultants PA
• Dallas Pulmonary & Sleep Clinic

• Chiropractor in Mansfield, TX
• Providers in Mansfield, TX by specialty
• Chiropractor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2014; 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.