Individual provider Active NPI

Payton James Holderman DC, DC

  • Chiropractor
  • Dallas, TX
National Provider Identifier
1609559053
Registry record updated Aug 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
14617 Issued in TX
Practice address
2821 McKinney Ave Ste 3
Dallas, TX 75204-2549
Phone
(979) 255-4949
NPI assigned
Aug 11, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 14617 TX Primary

Addresses

Primary practice location

2821 McKinney Ave Ste 3
Dallas, TX 75204-2549

Mailing address

2821 McKinney Ave Ste 3
Dallas, TX 75204-2549
Phone (979) 255-4949

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
14617TXMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1691712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691712000000",
    "number": "1609559053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2821 MCKINNEY AVE STE 3",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752042549",
            "telephone_number": "979-255-4949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2821 MCKINNEY AVE STE 3",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752042549",
            "telephone_number": "979-255-4949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLDERMAN DC",
        "first_name": "PAYTON",
        "middle_name": "JAMES",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-11",
        "last_updated": "2023-08-11",
        "certification_date": "2023-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "14617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Aug 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.