Individual provider Active NPI

William Xavier Bratcher

  • Chiropractor
  • Tyler, TX
National Provider Identifier
1447207501
Registry record updated Dec 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC6197 Issued in TX
Practice address
2210 W Grande Blvd
Tyler, TX 75703-0554
Phone
(903) 561-6676
Fax
(903) 561-7071
NPI assigned
May 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Chiropractor 111NR0400X DC6197 TX
Chiropractor 111N00000X DC6197 TX Primary

Addresses

Primary practice location

2210 W Grande Blvd
Tyler, TX 75703-0554

Mailing address

2210 W Grande Blvd
Tyler, TX 75703-0554
Phone (903) 561-5757

Other identifiers 1

IdentifierTypeStateIssuer
001707102MedicaidTX

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081210000541 TX Practitioner - Chiropractic 7214098177 Reassigns benefits to 1 organization
Practice locations: Tyler, TX

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2210 W Grande Blvd
Tyler, TX 75703-0554
Phone (903) 561-6676

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Practice roles

OrganizationSpecialtyStatusNew patients
Bratcher Injury & Wellness Center, P.a. Rehabilitation CurrentSince Jan 13, 2020 Accepting new patients
Bratcher Chiropractic Diagnostic Center PC Rehabilitation Past Accepting new patients

Locations

2210 W Grande Blvd
Tyler, TX 75703
Phone (903) 561-5757

2140 W Grande Blvd
#A
Tyler, TX 75703
Phone (903) 251-2765

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609372800000",
    "number": "1447207501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2210 W GRANDE BLVD",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757030554",
            "telephone_number": "903-561-5757",
            "fax_number": "903-561-7071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2210 W GRANDE BLVD",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757030554",
            "telephone_number": "903-561-6676",
            "fax_number": "903-561-7071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRATCHER",
        "first_name": "WILLIAM",
        "middle_name": "XAVIER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-27",
        "last_updated": "2020-12-31",
        "certification_date": "2020-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "TX",
            "license": "DC6197",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "DC6197",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001707102",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2020; 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.