Individual provider Active NPI

Courtney D Sproul, DC

  • Chiropractor
  • Lubbock, TX
National Provider Identifier
1649776808
Registry record updated Apr 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
13703 Issued in TX
Practice address
5318 114TH St
Lubbock, TX 79424-6621
Phone
(806) 783-0644
NPI assigned
Apr 4, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 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 13703 TX Primary

Addresses

Primary practice location

5318 114TH St
Lubbock, TX 79424-6621

Mailing address

5318 114TH St
Lubbock, TX 79424-6621
Phone (806) 783-0644

Other names 1

  • Dr. Courtney D Martin Professional name

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL dr@legacyucc.com Epic Chiropractic, LLC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180523000300 TX Practitioner - Chiropractic 0941565980 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2017
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

5318 114TH St
Lubbock, TX 79424-6621
Phone (806) 783-0644

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Pure Legacy, LLC Chiropractor CurrentSince Apr 9, 2018 Accepting new patients

Locations

7021 Kewanee Ave
Unit 8101
Lubbock, TX 79424
Phone (806) 783-0644

Organizations & group practices 2

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": "1522800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712793600000",
    "number": "1649776808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5318 114TH ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794246621",
            "telephone_number": "806-783-0644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5318 114TH ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794246621",
            "telephone_number": "806-783-0644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPROUL",
        "first_name": "COURTNEY",
        "middle_name": "D",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-04",
        "last_updated": "2024-04-11",
        "certification_date": "2024-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "13703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "dr@legacyucc.com",
            "affiliation": "Y",
            "affiliationName": "Epic Chiropractic, LLC",
            "address_1": "7021 Kewanee Ave Unit 8101",
            "city": "Lubbock",
            "state": "TX",
            "country_code": "US",
            "postal_code": "794247050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "COURTNEY",
            "last_name": "MARTIN",
            "middle_name": "D",
            "prefix": "DR.",
            "credential": "D.C.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Lubbock, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2024; 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.

Verify at the official NPI Registry.