Organization Active NPI

Landmark Chiropractic LLC

  • Chiropractor
  • Waco, TX
National Provider Identifier
1487206173
Registry record updated Nov 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
LANDMARK CHIROPRACTIC LLC
Practice address
5201 Bosque Blvd Ste 240
Waco, TX 76710-4676
Phone
(830) 609-8866
NPI assigned
Jul 12, 2019
Last updated
Nov 5, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2019

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

Authorized official

Name
Andrew Oestreich, DCNPI 1427610765
Title
Provider
Phone
(830) 609-8866

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

5201 Bosque Blvd Ste 240
Waco, TX 76710-4676

Mailing address

5210 Bagby Ave Apt 335
Waco, TX 76711-2311

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191106002208 TX Part B Supplier - Clinic/Group Practice 6305178690 Receives reassigned benefits from 2 practitioners
Practice locations: Waco, TX

National Provider Directory

National Provider Directory

Locations

5201 Bosque Blvd
Ste 240
Waco, TX 76710
Phone (254) 265-7007

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1562889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1572912000000",
    "number": "1487206173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5210 BAGBY AVE APT 335",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767112311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5201 BOSQUE BLVD STE 240",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767104676",
            "telephone_number": "830-609-8866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LANDMARK CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-12",
        "last_updated": "2019-11-05",
        "status": "A",
        "authorized_official_last_name": "OESTREICH",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "830-609-8866",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waco, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.