Organization Active NPI

Dr Cameron Roe P.L.L.C.

  • Chiropractor
  • Anna, TX
National Provider Identifier
1578835633
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
DR CAMERON ROE P.L.L.C.
Practice address
2100 W White St Ste 230
Anna, TX 75409-5516
Phone
(972) 924-2286
Fax
(972) 924-4688
NPI assigned
Feb 6, 2012
Last updated
Jul 15, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2024

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

Authorized official

Name
Jackie Tarango
Title
Insurance and Billing Coordinator
Phone
(972) 924-2286

Specialties & licenses 1

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

Addresses

Primary practice location

2100 W White St Ste 230
Anna, TX 75409-5516

Mailing address

2100 W White St Ste 230
Anna, TX 75409-5516
Phone (972) 924-2286

Other identifiers 1

IdentifierTypeStateIssuer
613063OtherTXMEDICARE PTAN

Other names 2

  • Anna Chiropractic Center Former legal business name
  • Anna Disc Center Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140807001084 TX Part B Supplier - Clinic/Group Practice 8527285071 Receives reassigned benefits from 1 practitioner
Practice locations: Anna, TX

National Provider Directory

National Provider Directory
Tax ID family
Anna Chiropractic Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2100 W White St
Ste 230
Anna, TX 75409
Phone (972) 924-2286

Practitioners & affiliated clinicians

Practitioners 1

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": "1328486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721001600000",
    "number": "1578835633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 W WHITE ST STE 230",
            "city": "ANNA",
            "state": "TX",
            "postal_code": "754095516",
            "telephone_number": "972-924-2286",
            "fax_number": "972-924-4688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 W WHITE ST STE 230",
            "city": "ANNA",
            "state": "TX",
            "postal_code": "754095516",
            "telephone_number": "972-924-2286",
            "fax_number": "972-924-4688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR CAMERON ROE P.L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-06",
        "last_updated": "2024-07-15",
        "certification_date": "2024-07-15",
        "status": "A",
        "authorized_official_last_name": "TARANGO",
        "authorized_official_first_name": "JACKIE",
        "authorized_official_title_or_position": "INSURANCE AND BILLING COORDINATOR",
        "authorized_official_telephone_number": "972-924-2286"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "613063",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Anna Chiropractic Center",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Anna Chiropractic Center",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Anna Disc Center",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Anna, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2024; 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.