Matthew Nannie, D.C.
Individual provider Active NPI Chiropractor · Forney, TX, TX
NPI 1457734477 · NPPES record last updated Feb 9, 2023
Key facts
- NPI
- 1457734477
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 15135 (TX)
- Practice address
- 11805 Classic LN
Forney, TX, TX 75126 - Phone
- (682) 706-2058
- NPI assigned
- Jul 8, 2015
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240212001418 | TX | Practitioner - Chiropractic | 9234572843 | Practice locations: Forney, TX |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 038012842 | IL | MD | Chiropractor |
| 15135 | TX | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Health Solutions of Morton, LLC | Chiropractor | Past |
Accepting new patients |
| Health Solutions Integrated Medi Care, PLLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 038012842 | IL | |
| Chiropractor | 111N00000X | 15135 | TX | Yes |
Addresses
Primary practice location
11805 Classic LN
Forney, TX, TX 75126
Mailing address
11805 Classic LN
Forney, TX 75126
Phone (682) 706-2058
Other practice location 1
1636 N Main St
Morton, IL 61550-9057
Phone (309) 284-0707
Other providers in Forney, TX, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 9, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.