100 Chiro Corona LLC
Organization Active NPI Chiropractor · Austin, TX
NPI 1487448189 · NPPES record last updated Apr 16, 2025
Key facts
- NPI
- 1487448189
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- Legal business name
- 100 CHIRO CORONA LLC
- Practice address
- 3800 N Lamar Blvd Ste 160
Austin, TX 78756-0002 - Phone
- (512) 638-8544
- NPI assigned
- Apr 7, 2025
- Organization subpart
- No
Authorized official
- Name
- Chris Corona
- Title
- Owner
- Phone
- (512) 638-8544
Practitioners 3
-
Nicolas L Kellerman, D.C.
-
Shauna Annie Wood, D.C.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20250709003252 | TX | Part B Supplier - Clinic/Group Practice | 1052825171 |
Receives reassigned benefits from 1 practitioner Practice locations: Austin, TX |
National Provider Directory
Locations
3800 N Lamar Blvd
Ste 160
Austin, TX 78756
Phone (512) 638-8544
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | Yes |
Addresses
Primary practice location
3800 N Lamar Blvd Ste 160
Austin, TX 78756-0002
Mailing address
3800 N Lamar Blvd Ste 160
Austin, TX 78756-0002
Phone (512) 638-8544
Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 16, 2025. 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.