Michael Brandon Pettke, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

9711 Issued in TX

Practice address

1320 NW John Jones Dr
Burleson, TX 76028-8040

Phone

(817) 297-7100

Fax

(817) 297-7193

NPI assigned

Jul 17, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Specialty

Chiropractic

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Lone Star Progressive Medicine of Burleson PA

  • General Practice Physician
  • Burleson, TX
  • NPI 1437668951
  Medicare reassignment NPD Authorized official
• Healthsource of Frisco LLC

  • Chiropractor
  • Frisco, TX
  • NPI 1699028084
  NPD (past)
• Healthsource of Mansfield Texas LLC

  • Chiropractor
  • Mansfield, TX
  • NPI 1629346382
  NPD (past)
• Healthsource of South Lake LLC

  • Chiropractor
  • Southlake, TX
  • NPI 1396025151
  NPD (past)

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581465600000",
    "number": "1730107889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1320 NW JOHN JONES DR",
            "city": "BURLESON",
            "state": "TX",
            "postal_code": "760288040",
            "telephone_number": "817-297-7100",
            "fax_number": "817-297-7193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 NW JOHN JONES DR",
            "city": "BURLESON",
            "state": "TX",
            "postal_code": "760288040",
            "telephone_number": "817-297-7100",
            "fax_number": "817-297-7193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTKE",
        "first_name": "MICHAEL",
        "middle_name": "BRANDON",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2020-02-12",
        "certification_date": "2020-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "9711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William M Perryman, MD
• Peter Green MD PA
• Christopher Petr, MD
• Sarah E Petry, PT, DPT, ATC, LAT
• Samantha Pettit, LPC
• Nancy Kim Pham, DDS
• Ryan Pham, D.O
• Teena Pham
• Physio Group, PLLC
• Joanne Joycelyn Picton, NP

• Chiropractor in Burleson, TX
• Providers in Burleson, TX by specialty
• Chiropractor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2020; 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.