Organization Active NPI

Pecan Country Chiropractic, LLC

  • Chiropractor
  • Seguin, TX
National Provider Identifier
1699181586
Registry record updated Jul 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
12245 Issued in TX
Legal business name
PECAN COUNTRY CHIROPRACTIC, LLC
Practice address
1300 N King St
Seguin, TX 78155-3820
Phone
(830) 549-5232
Fax
(830) 549-5241
NPI assigned
Jul 11, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2014

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

Authorized official

Name
Dr. Dominic Anthony Scaramozi V, D.C.NPI 1093056764
Title
Chiropractor/Owner
Phone
(210) 289-5206

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 12245 TX Primary

Addresses

Primary practice location

1300 N King St
Seguin, TX 78155-3820

Mailing address

1300 N King St
Seguin, TX 78155-3820
Phone (830) 549-5232

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150226000936 TX Part B Supplier - Clinic/Group Practice 2567788110 Receives reassigned benefits from 2 practitioners
Practice locations: Seguin, TX

National Provider Directory

National Provider Directory

Locations

1300 N King St
Seguin, TX 78155
Phone (830) 549-5232

Practitioners & affiliated clinicians

Practitioners 3

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": "1405036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405036800000",
    "number": "1699181586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 N KING ST",
            "city": "SEGUIN",
            "state": "TX",
            "postal_code": "781553820",
            "telephone_number": "830-549-5232",
            "fax_number": "830-549-5241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 N KING ST",
            "city": "SEGUIN",
            "state": "TX",
            "postal_code": "781553820",
            "telephone_number": "830-549-5232",
            "fax_number": "830-549-5241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PECAN COUNTRY CHIROPRACTIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-11",
        "last_updated": "2014-07-11",
        "status": "A",
        "authorized_official_last_name": "SCARAMOZI",
        "authorized_official_first_name": "DOMINIC",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "CHIROPRACTOR/OWNER",
        "authorized_official_telephone_number": "210-289-5206",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "V",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "12245",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seguin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2014; 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.