Individual provider Active NPI

Christian Poldrack, DC

  • Chiropractor
  • Midland, TX
National Provider Identifier
1578023834
Registry record updated Mar 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
13932 Issued in TX
Practice address
3408 N Midkiff Rd Ste 307
Midland, TX 79705-4836
Phone
(432) 614-0888
NPI assigned
Mar 22, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 13932 TX Primary

Addresses

Primary practice location

3408 N Midkiff Rd Ste 307
Midland, TX 79705-4836

Mailing address

3408 N Midkiff Rd Ste 307
Midland, TX 79705-4836
Phone (432) 614-0888

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190610002433 TX Practitioner - Chiropractic 4789917543 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3408 N Midkiff Rd
Suite 307
Midland, TX 79705-4836
Phone (432) 614-0888

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13932TXMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Society Chiropractic Company LLC Chiropractor CurrentSince May 6, 2019 Accepting new patients

Locations

3408 N Midkiff Rd
Ste 307
Midland, TX 79705
Phone (432) 614-0888

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1553212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553212800000",
    "number": "1578023834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3408 N MIDKIFF RD STE 307",
            "city": "MIDLAND",
            "state": "TX",
            "postal_code": "797054836",
            "telephone_number": "432-614-0888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3408 N MIDKIFF RD STE 307",
            "city": "MIDLAND",
            "state": "TX",
            "postal_code": "797054836",
            "telephone_number": "432-614-0888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLDRACK",
        "first_name": "CHRISTIAN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-22",
        "last_updated": "2019-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "13932",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midland, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.