Organization Active NPI

Ebcmd PLLC

Doing business as Texas Joint and Spine Centers

  • Chiropractor
  • Dallas, TX
National Provider Identifier
1568914943
Registry record updated Nov 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
EBCMD PLLC
Doing business as
Texas Joint and Spine Centers
Practice address
411 N Washington Ave Ste 2600
Dallas, TX 75246-1713
Phone
(469) 334-0624
Fax
(214) 269-7547
NPI assigned
Nov 1, 2016
Last updated
Nov 3, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2020

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

Authorized official

Name
Dr. Adam Bohnenblust, DCNPI 1528505096
Title
President
Phone
(469) 334-0624

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X
Chiropractor 111N00000X Primary
Internal Medicine Physician 207R00000X

Addresses

Primary practice location

411 N Washington Ave Ste 2600
Dallas, TX 75246-1713

Mailing address

411 N Washington Ave Ste 2600
Dallas, TX 75246-1713
Phone (469) 334-0624

Other practice location 1

4015 Main St
Dallas, TX 75226-1231
Phone (469) 334-0624

Other names 1

  • Texas Joint and Spine Centers Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201210000309 TX Part B Supplier - Clinic/Group Practice 6507278884 Receives reassigned benefits from 2 practitioners
Practice locations: Dallas, TX

National Provider Directory

National Provider Directory

Locations

411 N Washington Ave
Ste 2600
Dallas, TX 75246
Phone (214) 699-4077

Practitioners & affiliated clinicians

Practitioners 4

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": "1477958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604361600000",
    "number": "1568914943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 N WASHINGTON AVE STE 2600",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752461713",
            "telephone_number": "469-334-0624",
            "fax_number": "214-269-7547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 N WASHINGTON AVE STE 2600",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752461713",
            "telephone_number": "469-334-0624",
            "fax_number": "214-269-7547"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4015 Main St",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752261231",
            "country_code": "US",
            "telephone_number": "469-334-0624",
            "fax_number": "214-269-7547",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EBCMD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-01",
        "last_updated": "2020-11-03",
        "certification_date": "2020-11-03",
        "status": "A",
        "authorized_official_last_name": "BOHNENBLUST",
        "authorized_official_first_name": "ADAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "469-334-0624",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Texas Joint and Spine Centers",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2020; 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.