NPIMap

Organization Active NPI

Lake Travis Chiropractic, PLLC

  • Chiropractor
  • Lakeway, TX
National Provider Identifier
1396187589
Registry record updated Oct 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
F0010454 Issued in TX
Legal business name
LAKE TRAVIS CHIROPRACTIC, PLLC
Practice address
1603 Ranch Road 620 N
Lakeway, TX 78734-2693
Phone
(512) 548-6576
NPI assigned
Jul 29, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2014

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

Authorized official

Name
Mariska Visser, D.C.NPI 1558443366
Title
Owner/Sole Member
Phone
(512) 548-6576

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X F0010454 TX Primary

Addresses

Primary practice location

1603 Ranch Road 620 N
Lakeway, TX 78734-2693

Mailing address

6 Wingreen Loop
The Hills, TX 78738-1522
Phone (512) 548-6576

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1375056000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412899200000",
    "number": "1396187589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 WINGREEN LOOP",
            "city": "THE HILLS",
            "state": "TX",
            "postal_code": "787381522",
            "telephone_number": "512-548-6576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1603 RANCH ROAD 620 N",
            "city": "LAKEWAY",
            "state": "TX",
            "postal_code": "787342693",
            "telephone_number": "512-548-6576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE TRAVIS CHIROPRACTIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-29",
        "last_updated": "2014-10-10",
        "status": "A",
        "authorized_official_last_name": "VISSER",
        "authorized_official_first_name": "MARISKA",
        "authorized_official_title_or_position": "OWNER/SOLE MEMBER",
        "authorized_official_telephone_number": "512-548-6576",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "F0010454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeway, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2014; 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.