Individual provider Active NPI

Bill Wayne Enlow, D.C.

  • Chiropractor
  • Fort Worth, TX
National Provider Identifier
1720102064
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4390 Issued in TX
Practice address
6805 NE Loop 820
Suite 414
Fort Worth, TX 76180-6687
Phone
(817) 581-7246
Fax
(817) 581-7248
NPI assigned
Mar 19, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4390 TX Primary

Addresses

Primary practice location

6805 NE Loop 820
Suite 414
Fort Worth, TX 76180-6687

Mailing address

6805 NE Loop 820
Suite 414
Fort Worth, TX 76180-6687
Phone (817) 581-7246

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
4390TXMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1720102064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6805 NE LOOP 820",
            "address_2": "SUITE 414",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761806687",
            "telephone_number": "817-581-7246",
            "fax_number": "817-581-7248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6805 NE LOOP 820",
            "address_2": "SUITE 414",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761806687",
            "telephone_number": "817-581-7246",
            "fax_number": "817-581-7248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENLOW",
        "first_name": "BILL",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "4390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.