Healthsource of Copperfield, LLC

Primary specialty

Rehabilitation ChiropractorTaxonomy code 111NR0400X

License

11457 Issued in TX

Legal business name

HEALTHSOURCE OF COPPERFIELD, LLC

Doing business as

HealthSource Chiropractic and Progressive Rehab

Practice address

8711 Highway 6 N Ste 210
Houston, TX 77095-2272

Phone

(281) 858-4446

NPI assigned

Jun 17, 2016

Last updated

Oct 3, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Elizabeth Smith Cook, DC

Title

Owner

Phone

(214) 519-1755

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• HealthSource Chiropractic and Progressive Rehab Doing business as

Locations

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

{
    "created_epoch": "1466121600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1538524800000",
    "number": "1639529811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8925 HIGHWAY 6 N",
            "address_2": "SUITE 200",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770952457",
            "telephone_number": "281-858-4446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8711 HIGHWAY 6 N STE 210",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770952272",
            "telephone_number": "281-858-4446"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8925 Highway 6 N",
            "address_2": "suite 200",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770952457",
            "country_code": "US",
            "telephone_number": "281-858-4446",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "HEALTHSOURCE OF COPPERFIELD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-17",
        "last_updated": "2018-10-03",
        "status": "A",
        "authorized_official_last_name": "SMITH COOK",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "214-519-1755",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Rehabilitation",
            "state": "TX",
            "license": "11457",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "410526ZK5A",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HealthSource Chiropractic and Progressive Rehab",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "HealthSource Chiropractic and Progressive Rehab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2018; 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.