Individual provider Active NPI

Robert John Wolff, D.C

  • Chiropractor
  • Vernon, TX
National Provider Identifier
1427046747
Registry record updated Jul 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC4310 Issued in TX
Practice address
3720 Wilbarger St
Vernon, TX 76384-3259
Phone
(940) 552-9951
Fax
(940) 552-2382
NPI assigned
Oct 11, 2005
Last updated
Jul 22, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 22, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC4310 TX Primary

Addresses

Primary practice location

3720 Wilbarger St
Vernon, TX 76384-3259

Mailing address

3720 Wilbarger St
Vernon, TX 76384-3287
Phone (940) 552-9951

Other identifiers 2

IdentifierTypeStateIssuer
8M5954OtherTXBLUE CROSS BLUE SHIELD OF
00313096-01MedicaidTX

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090403000222 TX Practitioner - Chiropractic 3678620853 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3720 Wilbarger St
Vernon, TX 76384-3259
Phone (940) 552-9951

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC4310TXMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Wolff Chiropractic Wellness Center P.a. Chiropractor CurrentSince Feb 9, 2009 Accepting new patients
Back in Balance Chiropractor CurrentSince Feb 9, 2025 Accepting new patients

Locations

3720 Wilbarger St
Vernon, TX 76384
Phone (940) 357-9447

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1128988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658448000000",
    "number": "1427046747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3720 WILBARGER ST",
            "city": "VERNON",
            "state": "TX",
            "postal_code": "763843287",
            "telephone_number": "940-552-9951",
            "fax_number": "940-552-2382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3720 WILBARGER ST",
            "city": "VERNON",
            "state": "TX",
            "postal_code": "763843259",
            "telephone_number": "940-552-9951",
            "fax_number": "940-552-2382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLFF",
        "first_name": "ROBERT",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "D.C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-11",
        "last_updated": "2022-07-22",
        "certification_date": "2022-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "DC4310",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF",
            "identifier": "8M5954",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00313096-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vernon, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2022; 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.