Active NPI
Jerry Wayne Duvall, D.C.
- Sports Physician Chiropractor
- Harlingen, TX
National Provider Identifier
1801949177
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Physician Chiropractor
- License
- 5960
- Practice address
- 1514 S 77 Sunshinestrip
Suite 19
Harlingen, TX 78550-7208 - Phone
- (956) 425-6932
- Fax
- (956) 425-6933
- NPI assigned
- Jan 19, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Physician Chiropractor | 111NS0005X | 5960 | TX | Primary |
Addresses
Primary practice location
1514 S 77 Sunshinestrip
Suite 19
Harlingen, TX 78550-7208
Mailing address
1514 S 77 Sunshinestrip
Suite 19
Harlingen, TX 78550-7208
Phone (956) 425-6932
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 605139 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070505000147 | TX | Practitioner - Chiropractic | 7719083856 | Practice locations: Harlingen, TX |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Other, 1991
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1514 S 77 Sunshine Strip
Suite 19
Harlingen, TX 78550-8186
Phone (956) 425-6932
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5960 | TX | MD | Sports Physician Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169164800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1218672000000",
"number": "1801949177",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1514 S 77 SUNSHINESTRIP",
"address_2": "SUITE 19",
"city": "HARLINGEN",
"state": "TX",
"postal_code": "785507208",
"telephone_number": "956-425-6932",
"fax_number": "956-425-6933"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1514 S 77 SUNSHINESTRIP",
"address_2": "SUITE 19",
"city": "HARLINGEN",
"state": "TX",
"postal_code": "785507208",
"telephone_number": "956-425-6932",
"fax_number": "956-425-6933"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUVALL",
"first_name": "JERRY",
"middle_name": "WAYNE",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-19",
"last_updated": "2008-08-14",
"status": "A"
},
"taxonomies": [
{
"code": "111NS0005X",
"taxonomy_group": "",
"desc": "Chiropractor, Sports Physician",
"state": "TX",
"license": "5960",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "605139",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Harlingen, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2008; 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.