NPIMap

Organization Active NPI

Desoto Injury Rehab LLC

  • Rehabilitation Chiropractor
  • Desoto, TX
National Provider Identifier
1457742744
Registry record updated Feb 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation ChiropractorTaxonomy code 111NR0400X
License
F0011366 Issued in TX
Legal business name
DESOTO INJURY REHAB LLC
Practice address
509 N Hampton Rd Ste 100a
Desoto, TX 75115-4970
Phone
(469) 297-6575
Fax
(469) 533-0307
NPI assigned
Feb 9, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2015

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

Authorized official

Name
Mr. David Long
Title
Partner
Phone
(469) 297-6575

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111NR0400X F0011366 TX Primary

Addresses

Primary practice location

509 N Hampton Rd Ste 100a
Desoto, TX 75115-4970

Mailing address

509 N Hampton Rd Ste 100a
Desoto, TX 75115-4970
Phone (469) 297-6575

National Provider Directory

National Provider Directory

Locations

509 N Hampton Rd
Ste 100A
Desoto, TX 75115
Phone (469) 297-6575

Practitioners & affiliated clinicians

Practitioners 3

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": "1423440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423440000000",
    "number": "1457742744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 N HAMPTON RD STE 100A",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751154970",
            "telephone_number": "469-297-6575",
            "fax_number": "469-533-0307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 N HAMPTON RD STE 100A",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751154970",
            "telephone_number": "469-297-6575",
            "fax_number": "469-533-0307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESOTO INJURY REHAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-09",
        "last_updated": "2015-02-09",
        "status": "A",
        "authorized_official_last_name": "LONG",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "469-297-6575",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Rehabilitation",
            "state": "TX",
            "license": "F0011366",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Desoto, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.