Active NPI
Corey John Rizzo, DC
- Chiropractor
- Port Arthur, TX
National Provider Identifier
1649389354
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 8325
- Practice address
- 5037 Gulfway Dr
Port Arthur, TX 77642 - Phone
- (409) 982-7716
- Fax
- (409) 983-7792
- NPI assigned
- Aug 29, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 8325 | TX | Primary |
Addresses
Primary practice location
5037 Gulfway Dr
Port Arthur, TX 77642
Mailing address
5037 Gulfway Dr
Port Arthur, TX 77642
Phone (409) 982-7716
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8325 | Other | TX | DC LICENSE |
| 2275372 | Other | TX | AETN |
| 606017 | Other | TX | BCBS LICENSE |
| 8276496 | Other | TX | BLUE LINK |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120507000135 | TX | Practitioner - Chiropractic | 9830351956 | Practice locations: Port Arthur, TX |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Other, 1999
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
5037 Gulfway Dr
Port Arthur, TX 77642-1725
Phone (409) 982-7716
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8325 | TX | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156809600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1649389354",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5037 GULFWAY DR",
"city": "PORT ARTHUR",
"state": "TX",
"postal_code": "77642",
"telephone_number": "409-982-7716",
"fax_number": "409-983-7792"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5037 GULFWAY DR",
"city": "PORT ARTHUR",
"state": "TX",
"postal_code": "77642",
"telephone_number": "409-982-7716",
"fax_number": "409-983-7792"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIZZO",
"first_name": "COREY",
"middle_name": "JOHN",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-29",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "TX",
"license": "8325",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DC LICENSE",
"identifier": "8325",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETN",
"identifier": "2275372",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS LICENSE",
"identifier": "606017",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE LINK",
"identifier": "8276496",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Port Arthur, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.