Organization Active NPI

SRB Wellness Inc

Doing business as Alliance Chiropractic and Massage

  • Chiropractor
  • Watauga, TX
National Provider Identifier
1639449812
Registry record updated Aug 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
8220 Issued in TX
Legal business name
SRB WELLNESS INC
Doing business as
Alliance Chiropractic and Massage
Practice address
5710 Watauga Rd
Suite a
Watauga, TX 76148-3022
Phone
(817) 281-0008
Fax
(817) 281-7333
NPI assigned
Jan 5, 2012
Last updated
Aug 29, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2013

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

Authorized official

Name
Dr. Jeffrey Scott Ruth, D.C.NPI 1134205784
Title
President / Provider
Phone
(817) 281-0008

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 8220 TX Primary

Addresses

Primary practice location

5710 Watauga Rd
Suite a
Watauga, TX 76148-3022

Mailing address

5710 Watauga Rd
Suite a
Watauga, TX 76148-3022
Phone (817) 281-0008

Other names 1

  • Alliance Chiropractic and Massage Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120412000746 TX Part B Supplier - Clinic/Group Practice 8820259112 Receives reassigned benefits from 2 practitioners
Practice locations: Watauga, TX

National Provider Directory

National Provider Directory

Locations

5710 Watauga Rd
Ste A
Watauga, TX 76148
Phone (817) 281-0008

5720 Watauga Rd
Ste 100
Watauga, TX 76148
Phone (817) 281-0008

Practitioners & affiliated clinicians

Practitioners 2

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": "1325721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1377734400000",
    "number": "1639449812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5710 WATAUGA RD",
            "address_2": "SUITE A",
            "city": "WATAUGA",
            "state": "TX",
            "postal_code": "761483022",
            "telephone_number": "817-281-0008",
            "fax_number": "817-281-7333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5710 WATAUGA RD",
            "address_2": "SUITE A",
            "city": "WATAUGA",
            "state": "TX",
            "postal_code": "761483022",
            "telephone_number": "817-281-0008",
            "fax_number": "817-281-7333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SRB WELLNESS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-05",
        "last_updated": "2013-08-29",
        "status": "A",
        "authorized_official_last_name": "RUTH",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "PRESIDENT / PROVIDER",
        "authorized_official_telephone_number": "817-281-0008",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "8220",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Alliance Chiropractic and Massage",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Watauga, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2013; 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.