Individual provider Active NPI

Kevin Wayne Smith, D.C.

  • Chiropractor
  • Dallas, TX
National Provider Identifier
1609872613
Registry record updated Feb 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
9374 Issued in TX
Practice address
7015 Snider PLZ
Ste 225
Dallas, TX 75205-5642
Phone
(214) 691-9355
Fax
(214) 691-9360
NPI assigned
Jun 23, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 9374 TX Primary

Addresses

Primary practice location

7015 Snider PLZ
Ste 225
Dallas, TX 75205-5642

Mailing address

7015 Snider PLZ
Ste 225
Dallas, TX 75205-5642
Phone (214) 691-9355

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110225000262 TX Practitioner - Chiropractic 1153486600 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2002
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

7015 Snider PLZ
Suite 225
Dallas, TX 75205-5642
Phone (214) 691-9355

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9374TXMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity Family Chiropractic PC Chiropractor CurrentSince Dec 12, 2002 Accepting new patients

Locations

7015 Snider Plz
Ste 225
Dallas, TX 75205
Phone (214) 691-9355

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": "1119484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298851200000",
    "number": "1609872613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7015 SNIDER PLZ",
            "address_2": "STE 225",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752055642",
            "telephone_number": "214-691-9355",
            "fax_number": "214-691-9360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7015 SNIDER PLZ",
            "address_2": "STE 225",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752055642",
            "telephone_number": "214-691-9355",
            "fax_number": "214-691-9360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KEVIN",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-23",
        "last_updated": "2011-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "9374",
            "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 Feb 28, 2011; 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.