Organization Active NPI

Carmack Chiropractic and Sports Therapy

  • Sports Physician Chiropractor
  • Flower Mound, TX
National Provider Identifier
1649604380
Registry record updated Jul 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
License
10941 Issued in TX
Legal business name
CARMACK CHIROPRACTIC AND SPORTS THERAPY
Practice address
3700 River Walk Dr
Suite 165
Flower Mound, TX 75028-1812
Phone
(972) 899-9818
Fax
(972) 899-9819
NPI assigned
Aug 29, 2013
Last updated
Jul 15, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2015

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

Authorized official

Name
Billy D CarmackNPI 1407002306
Title
Owner
Phone
(469) 262-9681

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
Sports Physician Chiropractor 111NS0005X 10941 TX Primary

Addresses

Primary practice location

3700 River Walk Dr
Suite 165
Flower Mound, TX 75028-1812

Mailing address

3700 River Walk Dr
Suite 165
Flower Mound, TX 75028-1812
Phone (972) 899-9818

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150902001339 TX Part B Supplier - Clinic/Group Practice 2668788811 Receives reassigned benefits from 1 practitioner
Practice locations: Lewisville, TX

National Provider Directory

National Provider Directory

Locations

3700 River Walk Dr
Ste 165
Flower Mound, TX 75028
Phone (972) 899-9818

200 Continental Dr
Lewisville, TX 75067
Phone (972) 899-9818

Practitioners & affiliated clinicians

Practitioners 1

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": "1377734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436918400000",
    "number": "1649604380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 RIVER WALK DR",
            "address_2": "SUITE 165",
            "city": "FLOWER MOUND",
            "state": "TX",
            "postal_code": "750281812",
            "telephone_number": "972-899-9818",
            "fax_number": "972-899-9819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 RIVER WALK DR",
            "address_2": "SUITE 165",
            "city": "FLOWER MOUND",
            "state": "TX",
            "postal_code": "750281812",
            "telephone_number": "972-899-9818",
            "fax_number": "972-899-9819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARMACK CHIROPRACTIC AND SPORTS THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-29",
        "last_updated": "2015-07-15",
        "status": "A",
        "authorized_official_last_name": "CARMACK",
        "authorized_official_first_name": "BILLY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "469-262-9681"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "TX",
            "license": "10941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flower Mound, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2015; 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.