Organization Active NPI

Woolverton Chiropractic DC PC

  • Chiropractor
  • Richardson, TX
National Provider Identifier
1689859282
Registry record updated Mar 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4828 Issued in TX
Legal business name
WOOLVERTON CHIROPRACTIC DC PC
Practice address
2093 N Collins Blvd Ste 105
Richardson, TX 75080-8302
Phone
(972) 231-4231
Fax
(972) 907-8900
NPI assigned
Jan 2, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2010

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

Authorized official

Name
Dr. Ward Bentley Woolverton, DCNPI 1326143231
Title
President
Phone
(972) 231-4231

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
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 4828 TX Primary

Addresses

Primary practice location

2093 N Collins Blvd Ste 105
Richardson, TX 75080-8302

Mailing address

2093 N Collins Blvd Ste 105
Richardson, TX 75080-8302
Phone (972) 231-4231

Other identifiers 1

IdentifierTypeStateIssuer
00T33UOtherTXBLUE CROSS BLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080414000653 TX Part B Supplier - Clinic/Group Practice 4880771963 Receives reassigned benefits from 1 practitioner
Practice locations: Richardson, TX

National Provider Directory

National Provider Directory

Locations

2093 N Collins Blvd
Ste 105
Richardson, TX 75080
Phone (972) 231-4231

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1199232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1267747200000",
    "number": "1689859282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2093 N COLLINS BLVD STE 105",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750808302",
            "telephone_number": "972-231-4231",
            "fax_number": "972-907-8900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2093 N COLLINS BLVD STE 105",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750808302",
            "telephone_number": "972-231-4231",
            "fax_number": "972-907-8900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOOLVERTON CHIROPRACTIC DC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-02",
        "last_updated": "2010-03-05",
        "status": "A",
        "authorized_official_last_name": "WOOLVERTON",
        "authorized_official_first_name": "WARD",
        "authorized_official_middle_name": "BENTLEY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "972-231-4231",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "4828",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "00T33U",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richardson, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2010; 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.