Individual provider Active NPI

Cristin Vitek Wafer, D.C.

  • Chiropractor
  • Katy, TX
National Provider Identifier
1427366780
Registry record updated Sep 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
11565 Issued in TX
Practice address
505 S Mason Rd
Katy, TX 77450-2491
Phone
(281) 579-1116
Fax
(281) 579-0395
NPI assigned
Sep 21, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 11565 TX Primary

Addresses

Primary practice location

505 S Mason Rd
Katy, TX 77450-2491

Mailing address

505 S Mason Rd
Katy, TX 77450-2491
Phone (281) 579-1116

Other identifiers 2

IdentifierTypeStateIssuer
TXB114991OtherTXMEDICARE INDIVIDUAL PTAN
601426OtherTXMEDICARE GROUP PTAN

Other names 1

  • Cristin Dianne Vitek Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110104000358 TX Practitioner - Chiropractic 9638368822 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

707 S Fry Rd
Suite 475
Katy, TX 77450-2260
Phone (281) 579-1116

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11565TXMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Katy Chiropractic Clinic, LLC Chiropractor CurrentSince Feb 8, 2022 Accepting new patients

Locations

505 S Mason Rd
Katy, TX 77450
Phone (281) 579-1116

707 S Fry Rd
Ste 475
Katy, TX 77450
Phone (281) 579-1116

Organizations & group practices 1

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": "1285027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346716800000",
    "number": "1427366780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 S MASON RD",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774502491",
            "telephone_number": "281-579-1116",
            "fax_number": "281-579-0395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 S MASON RD",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774502491",
            "telephone_number": "281-579-1116",
            "fax_number": "281-579-0395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAFER",
        "first_name": "CRISTIN",
        "middle_name": "VITEK",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-21",
        "last_updated": "2012-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "11565",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE INDIVIDUAL PTAN",
            "identifier": "TXB114991",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PTAN",
            "identifier": "601426",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CRISTIN",
            "last_name": "VITEK",
            "middle_name": "DIANNE",
            "credential": "D.C.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Katy, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2012; 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.