Modus Vivendi Chiropractic PLLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

11576 Issued in TX

Legal business name

MODUS VIVENDI CHIROPRACTIC PLLC

Practice address

4120 N Collins St Ste 200
Arlington, TX 76005-4554

Phone

(817) 557-2770

Fax

(817) 557-1795

NPI assigned

Oct 19, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Kenyon Godwin, D.C.NPI 1417266016

Title

President/Owner

Phone

(817) 557-2770

Specialties & licenses 1

Addresses

Other names 2

• Active Family Wellness Center Doing business as
• Modus Vivendi Chiropractic Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kenyon Godwin, D.C.

  • Chiropractor
  • Arlington, TX
  • NPI 1417266016
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1287446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719532800000",
    "number": "1801106299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4120 N COLLINS ST STE 200",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760054554",
            "telephone_number": "817-557-2770",
            "fax_number": "817-557-1795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4120 N COLLINS ST STE 200",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760054554",
            "telephone_number": "817-557-2770",
            "fax_number": "817-557-1795"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4927 S Collins St Ste 105",
            "address_purpose": "LOCATION",
            "city": "Arlington",
            "state": "TX",
            "postal_code": "760181167",
            "country_code": "US",
            "telephone_number": "817-557-2770",
            "fax_number": "817-557-1795",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MODUS VIVENDI CHIROPRACTIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-19",
        "last_updated": "2024-06-28",
        "certification_date": "2024-06-28",
        "status": "A",
        "authorized_official_last_name": "GODWIN",
        "authorized_official_first_name": "KENYON",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "817-557-2770",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "11576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Active Family Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Modus Vivendi Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2024; 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.