Organization Active NPI

Rose Chiropractic & Wellness

  • Chiropractor
  • Fort Worth, TX
National Provider Identifier
1427316025
Registry record updated Jul 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
11145 Issued in TX
Legal business name
ROSE CHIROPRACTIC & WELLNESS
Practice address
3529 Heritage Trace Pkwy
155
Fort Worth, TX 76244-4970
Phone
(214) 704-4144
Fax
(972) 317-4196
NPI assigned
May 2, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2012

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

Authorized official

Name
Dr. Dustin Rose, D.C.NPI 1407136591
Title
Owner/Chiropractor
Phone
(214) 704-4144

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 11145 TX Primary

Addresses

Primary practice location

3529 Heritage Trace Pkwy
155
Fort Worth, TX 76244-4970

Mailing address

3529 Heritage Trace Pkwy
155
Fort Worth, TX 76244-4970

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120725000687 TX Part B Supplier - Clinic/Group Practice 1153587795 Receives reassigned benefits from 1 practitioner
Practice locations: Decatur, TX; Fort Worth, TX

National Provider Directory

National Provider Directory

Locations

1816 S FM 51
Ste 1800
Decatur, TX 76234
Phone (940) 539-9247

3529 Heritage Trace Pkwy
Ste 155
Fort Worth, TX 76244
Phone (214) 704-4144

4909 Golden Triangle Blvd
Ste 221
Fort Worth, TX 76244
Phone (817) 741-8040

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

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": "1335916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1341187200000",
    "number": "1427316025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3529 HERITAGE TRACE PKWY",
            "address_2": "155",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762444970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3529 HERITAGE TRACE PKWY",
            "address_2": "155",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762444970",
            "telephone_number": "214-704-4144",
            "fax_number": "972-317-4196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROSE CHIROPRACTIC & WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-02",
        "last_updated": "2012-07-02",
        "status": "A",
        "authorized_official_last_name": "ROSE",
        "authorized_official_first_name": "DUSTIN",
        "authorized_official_title_or_position": "OWNER/CHIROPRACTOR",
        "authorized_official_telephone_number": "214-704-4144",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "11145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2012; 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.