Active NPI
Jenny Lynn Marchuk, NMD, LAC
- Family Medicine Physician
- Dallas, TX
National Provider Identifier
1437810892
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- IPHMNC3256
- Practice address
- 17480 Dallas Pkwy Ste 212
Dallas, TX 75287-7362 - Phone
- (469) 617-8229
- Fax
- (915) 201-1658
- NPI assigned
- Jan 6, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 15
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Neuropsychologist | 103G00000X | IPHMNC3256 | TX | |
| Nutrition Chiropractor | 111NN1001X | IPHMNM8919 | TX | |
| Basic Emergency Medical Technician | 146N00000X | 67F29 | TX | |
| Acupuncturist | 171100000X | IPHMNC3256 | ||
| Naturopath | 175F00000X | TX | ||
| Sports Medicine (Neuromusculoskeletal Medicine) Physician | 204C00000X | IPHMNM8919 | TX | |
| Allergy Physician | 207KA0200X | IPHMNC3256 | TX | |
| Dermatology Physician | 207N00000X | IPHMNC3256 | TX | |
| Geriatric Medicine (Family Medicine) Physician | 207QG0300X | IPHMNC3256 | TX | |
| Critical Care Medicine (Obstetrics & Gynecology) Physician | 207VC0200X | CC38FF9D6453 | TX | |
| Neuromuscular Medicine (Psychiatry & Neurology) Physician | 2084N0008X | IPHMNC3256 | TX | |
| Rehabilitation Practitioner | 225400000X | IPHMNM8919 | ||
| Massage Therapist | 225700000X | TX | ||
| Kinesiotherapist | 226300000X | TX | ||
| Family Medicine Physician | 207Q00000X | IPHMNC3256 | TX | Primary |
Addresses
Primary practice location
17480 Dallas Pkwy Ste 212
Dallas, TX 75287-7362
Mailing address
17480 Dallas Pkwy Ste 212
Dallas, TX 75287-7362
Phone (682) 704-7842
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| IPHMNM8919 | TX | MD | Nutrition Chiropractor |
| 67F29 | TX | MD | Basic Emergency Medical Technician |
| IPHMNC3256 | TX | MD | Geriatric Medicine (Family Medicine) Physician |
| CC38FF9D6453 | TX | MD | Critical Care Medicine (Obstetrics & Gynecology) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Health and Wellness of Texas | Acupuncturist | Current | Accepting new patients |
Locations
17480 Dallas Pkwy
Ste 212
Dallas, TX 75287
Phone (469) 617-8229
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": "1641427200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1704931200000",
"number": "1437810892",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17480 DALLAS PKWY STE 212",
"city": "DALLAS",
"state": "TX",
"postal_code": "752877362",
"telephone_number": "682-704-7842",
"fax_number": "915-201-1658"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17480 DALLAS PKWY STE 212",
"city": "DALLAS",
"state": "TX",
"postal_code": "752877362",
"telephone_number": "469-617-8229",
"fax_number": "915-201-1658"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARCHUK",
"first_name": "JENNY",
"middle_name": "LYNN",
"name_prefix": "Dr.",
"credential": "NMD, LAC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-01-06",
"last_updated": "2024-01-11",
"certification_date": "2024-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "103G00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Clinical Neuropsychologist",
"state": "TX",
"license": "IPHMNC3256",
"primary": false
},
{
"code": "111NN1001X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Chiropractor, Nutrition",
"state": "TX",
"license": "IPHMNM8919",
"primary": false
},
{
"code": "146N00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Emergency Medical Technician, Basic",
"state": "TX",
"license": "67F29",
"primary": false
},
{
"code": "171100000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Acupuncturist",
"state": null,
"license": "IPHMNC3256",
"primary": false
},
{
"code": "175F00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Naturopath",
"state": "TX",
"license": null,
"primary": false
},
{
"code": "204C00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Neuromusculoskeletal Medicine, Sports Medicine",
"state": "TX",
"license": "IPHMNM8919",
"primary": false
},
{
"code": "207KA0200X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Allergy & Immunology, Allergy",
"state": "TX",
"license": "IPHMNC3256",
"primary": false
},
{
"code": "207N00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dermatology",
"state": "TX",
"license": "IPHMNC3256",
"primary": false
},
{
"code": "207QG0300X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine, Geriatric Medicine",
"state": "TX",
"license": "IPHMNC3256",
"primary": false
},
{
"code": "207VC0200X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Obstetrics & Gynecology, Critical Care Medicine",
"state": "TX",
"license": "CC38FF9D6453",
"primary": false
},
{
"code": "2084N0008X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychiatry & Neurology, Neuromuscular Medicine",
"state": "TX",
"license": "IPHMNC3256",
"primary": false
},
{
"code": "225400000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Rehabilitation Practitioner",
"state": null,
"license": "IPHMNM8919",
"primary": false
},
{
"code": "225700000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Massage Therapist",
"state": "TX",
"license": null,
"primary": false
},
{
"code": "226300000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Kinesiotherapist",
"state": "TX",
"license": null,
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": "TX",
"license": "IPHMNC3256",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.