Reactiv Sport and Spine, LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

REACTIV SPORT AND SPINE, LLC

Practice address

710 E Park Blvd Ste 110
Plano, TX 75074-8854

Phone

(972) 850-1446

NPI assigned

Nov 28, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Charles Tyler Allen, DCNPI 1912444647

Title

Owner

Phone

(972) 850-1446

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Charles Tyler Allen, D.C.

  • Chiropractor
  • Plano, TX
  • NPI 1912444647
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1701129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701129600000",
    "number": "1689440950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 E PARK BLVD STE 110",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750748854",
            "telephone_number": "972-850-1446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 E PARK BLVD STE 110",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750748854",
            "telephone_number": "972-850-1446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REACTIV SPORT AND SPINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-28",
        "last_updated": "2023-11-28",
        "certification_date": "2023-11-28",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "TYLER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "972-850-1446",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michele L Raymond, LPC
• Krystle Rayzer
• Rida Raza
• Samreen Rizvi Raza, M.D.
• Byron Razon
• Deanna Nicole Ready
• Realistic Expectations, PLLC
• Christen Leah Reamy, PA-C
• Reap II, Inc.
• Megan Reardon, DPT

• Chiropractor in Plano, TX
• Providers in Plano, TX by specialty
• Chiropractor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2023; 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.