Individual provider Active NPI

Scott T Bolz, D.C.

  • Chiropractor
  • Spring, TX
National Provider Identifier
1396730768
Registry record updated Oct 15, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
6962DC Issued in TX
Practice address
19510 Kuykendahl Rd # a
Spring, TX 77379-3408
Phone
(281) 651-7111
Fax
(281) 288-9550
NPI assigned
Sep 13, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 15, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 6962DC TX Primary

Addresses

Primary practice location

19510 Kuykendahl Rd # a
Spring, TX 77379-3408

Mailing address

19510 Kuykendahl Rd # a
Spring, TX 77379-3408
Phone (281) 651-7111

Other identifiers 1

IdentifierTypeStateIssuer
89770YOtherTXBC / BS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050127000525 TX Practitioner - ChiropracticPractitioner - Osteopathic Manipulative MedicinePractitioner - Sports Medicine 2860442878 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
ChiropracticAlso: Osteopathic Manipulative Medicine, Sports Medicine
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

19510 Kuykendahl Rd
Suite a
Spring, TX 77379-3481

19510 Kuykendahl Rd a
Spring, TX 77379-3481
Phone (281) 651-7111

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6962DCTXMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Spring Physical Therapy LLC Chiropractor Current Accepting new patients
Spring Chiropractic & Rehab PC Chiropractor CurrentSince Jun 19, 2000 Accepting new patients
Spring Sport & Spine, PLLC Chiropractor PastSince May 16, 2023 Accepting new patients

Locations

19510 Kuykendahl Rd
Ste A
Spring, TX 77379
Phone (281) 651-7111

4740 Spring Cypress Rd
#C
Spring, TX 77379
Phone (281) 655-7246

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1126569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192406400000",
    "number": "1396730768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19510 KUYKENDAHL RD # A",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773793408",
            "telephone_number": "281-651-7111",
            "fax_number": "281-288-9550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19510 KUYKENDAHL RD # A",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773793408",
            "telephone_number": "281-651-7111",
            "fax_number": "281-288-9550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLZ",
        "first_name": "SCOTT",
        "middle_name": "T",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-13",
        "last_updated": "2007-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "6962DC",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC / BS",
            "identifier": "89770Y",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spring, TX

Sources for this page

Verify at the official NPI Registry.