Individual provider Active NPI

Tony Wesley Deramus, DC

  • Sports Physician Chiropractor
  • Montgomery, TX
National Provider Identifier
1750494985
Registry record updated Sep 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
License
8344 Issued in TX
Practice address
123 Blue Heron Dr
Ste 104
Montgomery, TX 77316-3192
Phone
(936) 582-0404
Fax
(936) 582-0410
NPI assigned
Aug 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physician Chiropractor 111NS0005X 8344 TX Primary

Addresses

Primary practice location

123 Blue Heron Dr
Ste 104
Montgomery, TX 77316-3192

Mailing address

123 Blue Heron Dr
Ste 104
Montgomery, TX 77316-3192
Phone (936) 582-0404

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090209000664 TX Practitioner - Chiropractic 1557426442 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sandstone Chiropratic, P.a.Group PAC ID 0547325466, 2 clinicians

Practice addresses (Care Compare)

125 Blue Heron Dr
Suite B
Montgomery, TX 77316-3183
Phone (936) 582-0404

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sandstone Chiropractic the Woodlands, PLLC CurrentSince Aug 1, 2017 Accepting new patients
Sandstone Chiropractic Huntsville, PLLC CurrentSince Aug 10, 2024 Accepting new patients
Sandstone Chiropratic, P.a. Sports Physician CurrentSince Jul 1, 2008 Accepting new patients
Sandstone Chiropractic Conroe, PLLC CurrentSince Dec 11, 2016 Accepting new patients
Sandstone Medical PastSince Feb 1, 2018 Accepting new patients
John T Randolph Jr DC PC Past Accepting new patients
Sspmr, PLLC PastSince Jul 23, 2019 Accepting new patients
Sandstone Chiropractic Gosling, PLLC PastSince Mar 22, 2021 Accepting new patients
Lake Conroe Counseling Center, PLLC PastSince Nov 15, 2020 Accepting new patients
Sandstone Chiropractic Cypress, PLLC PastSince Jun 1, 2021 Accepting new patients
Sandstone Chiropractic Magnolia, PLLC PastSince Dec 1, 2013 Accepting new patients

Locations

1803 W White Oak Ter
Ste A
Conroe, TX 77304

227 State Highway 75 N
Ste 135
Huntsville, TX 77320
Phone (936) 253-5314

123 Blue Heron Dr
Ste 104
Montgomery, TX 77316
Phone (936) 449-8053

125 Blue Heron Dr
#B
Montgomery, TX 77316
Phone (936) 582-0404

3466 Discovery Creek Blvd
Ste 300
Spring, TX 77386
Phone (281) 203-0070

Interoperability endpoints

  • Direct secure messaging: doc@ssc0001.direct.chirotouch.md

Organizations & group practices 11

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315958400000",
    "number": "1750494985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 BLUE HERON DR",
            "address_2": "STE 104",
            "city": "MONTGOMERY",
            "state": "TX",
            "postal_code": "773163192",
            "telephone_number": "936-582-0404",
            "fax_number": "936-582-0410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 BLUE HERON DR",
            "address_2": "STE 104",
            "city": "MONTGOMERY",
            "state": "TX",
            "postal_code": "773163192",
            "telephone_number": "936-582-0404",
            "fax_number": "936-582-0410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERAMUS",
        "first_name": "TONY",
        "middle_name": "WESLEY",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-15",
        "last_updated": "2011-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "TX",
            "license": "8344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2011; 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.