Individual provider Active NPI

Bartholomew Gibbs Stevens, DC

  • Chiropractor
  • Burleson, TX
National Provider Identifier
1700943230
Registry record updated Apr 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
TX 5301 DC Issued in TX
Practice address
1001 Wilshire Blvd
Suite D
Burleson, TX 76028-5716
Phone
(817) 447-1414
Fax
(817) 447-3463
NPI assigned
Jan 3, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 17, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X TX 5301 DC TX Primary

Addresses

Primary practice location

1001 Wilshire Blvd
Suite D
Burleson, TX 76028-5716

Mailing address

1001 Wilshire Blvd
Suite D
Burleson, TX 76028-5716
Phone (817) 447-1414

Other identifiers 1

IdentifierTypeStateIssuer
8A7231OtherTXBLUE CROSS BLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090512000316 TX Practitioner - Chiropractic 8729137211 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chiropractic and Sports ClinicGroup PAC ID 1254489057, 2 clinicians

Practice addresses (Care Compare)

1001 SW Wilshire Blvd
Suite D
Burleson, TX 76028-5716
Phone (817) 447-1414

1649 W Henderson St
Suite a
Cleburne, TX 76033-4108

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
05301TXMDSocial Worker
TX 5301 DCTXMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Chiropractic & Sports Clinic Chiropractor CurrentSince Mar 4, 2009 Accepting new patients
Cleburne Integrated Wellness PA PastSince May 23, 2017 Accepting new patients

Locations

1001 SW Wilshire Blvd
Ste D
Burleson, TX 76028
Phone (817) 447-1414

821 N Nolan River Rd
Cleburne, TX 76033
Phone (817) 556-2000

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": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1239926400000",
    "number": "1700943230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 WILSHIRE BLVD",
            "address_2": "SUITE D",
            "city": "BURLESON",
            "state": "TX",
            "postal_code": "760285716",
            "telephone_number": "817-447-1414",
            "fax_number": "817-447-3463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 WILSHIRE BLVD",
            "address_2": "SUITE D",
            "city": "BURLESON",
            "state": "TX",
            "postal_code": "760285716",
            "telephone_number": "817-447-1414",
            "fax_number": "817-447-3463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENS",
        "first_name": "BARTHOLOMEW",
        "middle_name": "GIBBS",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-03",
        "last_updated": "2009-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "TX 5301 DC",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "8A7231",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burleson, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2009; 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.