Individual provider Active NPI

Kaci D Bartlett, DC

  • Chiropractor
  • Heath, TX
National Provider Identifier
1639930316
Registry record updated Jan 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
15883 Issued in TX
Practice address
4210 Ridge Rd Ste 102
Heath, TX 75032-1100
Phone
(972) 722-0054
NPI assigned
Jan 19, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 15883 TX Primary

Addresses

Primary practice location

4210 Ridge Rd Ste 102
Heath, TX 75032-1100

Mailing address

4210 Ridge Rd Ste 102
Heath, TX 75032-1100
Phone (972) 722-0054

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240207001897 TX Practitioner - Chiropractic 1355784307 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15883TXMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Waller Family Health Systems LLC CurrentSince Jan 22, 2024 Accepting new patients

Locations

4210 Ridge Rd
Ste 102
Rockwall, TX 75032
Phone (903) 342-5261

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": "1705622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705622400000",
    "number": "1639930316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4210 RIDGE RD STE 102",
            "city": "HEATH",
            "state": "TX",
            "postal_code": "750321100",
            "telephone_number": "972-722-0054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4210 RIDGE RD STE 102",
            "city": "HEATH",
            "state": "TX",
            "postal_code": "750321100",
            "telephone_number": "972-722-0054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARTLETT",
        "first_name": "KACI",
        "middle_name": "D",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-19",
        "last_updated": "2024-01-19",
        "certification_date": "2024-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "15883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Heath, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 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.