Individual provider Active NPI

Owen Bradford Whitenburg, D.C.

  • Rehabilitation Chiropractor
  • Corpus Christi, TX
National Provider Identifier
1720109077
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation ChiropractorTaxonomy code 111NR0400X
License
DC5203 Issued in TX
Practice address
3633 S Staples St
Corpus Christi, TX 78411-2438
Phone
(361) 225-2525
Fax
(361) 225-2530
NPI assigned
Apr 3, 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
Rehabilitation Chiropractor 111NR0400X DC5203 TX Primary

Addresses

Primary practice location

3633 S Staples St
Corpus Christi, TX 78411-2438

Mailing address

3633 S Staples St
Corpus Christi, TX 78411-2438
Phone (361) 225-2525

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171023002548 TX Practitioner - Chiropractic 9830465632 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC5203TXMDRehabilitation Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Call Hall, PC CurrentSince Oct 10, 2017 Accepting new patients

Locations

2407 S Congress Ave
Ste D
Austin, TX 78704
Phone (512) 442-2777

914 W Anderson Ln
Austin, TX 78757
Phone (512) 454-4072

Organizations & group practices 1

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": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1720109077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3633 S STAPLES ST",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784112438",
            "telephone_number": "361-225-2525",
            "fax_number": "361-225-2530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3633 S STAPLES ST",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784112438",
            "telephone_number": "361-225-2525",
            "fax_number": "361-225-2530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITENBURG",
        "first_name": "OWEN",
        "middle_name": "BRADFORD",
        "name_prefix": "Mr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "TX",
            "license": "DC5203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corpus Christi, 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.
  • 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.