Organization Active NPI

San Antonio Elite Chiropractic LLC

  • Chiropractor
  • San Antonio, TX
National Provider Identifier
1417476268
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
13219 Issued in TX
Legal business name
SAN ANTONIO ELITE CHIROPRACTIC LLC
Practice address
2397 NW Military Hwy Ste D
San Antonio, TX 78231-2543
Phone
(210) 342-3507
NPI assigned
Sep 13, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Dr. Matthew James, DCNPI 1699122309
Title
President
Phone
(830) 822-2953

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 13219 TX Primary

Addresses

Primary practice location

2397 NW Military Hwy Ste D
San Antonio, TX 78231-2543

Mailing address

2397 NW Military Hwy Ste D
San Antonio, TX 78231-2543
Phone (210) 342-3507

Other identifiers 2

IdentifierTypeStateIssuer
13219OtherTXTBCE
1699122309OtherMEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171206000432 TX Part B Supplier - Clinic/Group Practice 0749547453 Receives reassigned benefits from 1 practitioner
Practice locations: Live Oak, TX; San Antonio, TX

National Provider Directory

National Provider Directory

Locations

2397 NW Military Hwy
Ste D
San Antonio, TX 78231
Phone (210) 342-3507

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": "1505260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1417476268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2397 NW MILITARY HWY STE D",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782312543",
            "telephone_number": "210-342-3507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2397 NW MILITARY HWY STE D",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782312543",
            "telephone_number": "210-342-3507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN ANTONIO ELITE CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-13",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "JAMES",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "830-822-2953",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "13219",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TBCE",
            "identifier": "13219",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "1699122309",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.

Verify at the official NPI Registry.