Individual provider Active NPI

Larry D McIlroy, DC

  • Chiropractor
  • Levelland, TX
National Provider Identifier
1801990957
Registry record updated Apr 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5763 DC Issued in TX
Practice address
111 John Dupree Dr
Levelland, TX 79336
Phone
(806) 894-8119
Fax
(806) 894-2796
NPI assigned
Sep 11, 2006
Last updated
Apr 23, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5763 DC TX Primary

Addresses

Primary practice location

111 John Dupree Dr
Levelland, TX 79336

Mailing address

PO Box 459
Levelland, TX 79336-0459
Phone (806) 894-8119

Other identifiers 2

IdentifierTypeStateIssuer
8G5930OtherTXBLUE CROSS
1574915-01MedicaidTX

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120420000235 TX Practitioner - Chiropractic 2062673957 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

111 John Dupree Dr
Levelland, TX 79336-6326
Phone (806) 894-8119

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5763 DCTXMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Larry McIlroy Chiropractic Arts, P.a. Chiropractor CurrentSince Oct 28, 2001 Accepting new patients

Locations

111 John Dupree Dr
Levelland, TX 79336
Phone (806) 894-8119

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, 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": "1157932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335139200000",
    "number": "1801990957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 459",
            "city": "LEVELLAND",
            "state": "TX",
            "postal_code": "793360459",
            "telephone_number": "806-894-8119",
            "fax_number": "806-894-2796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 JOHN DUPREE DR",
            "city": "LEVELLAND",
            "state": "TX",
            "postal_code": "79336",
            "telephone_number": "806-894-8119",
            "fax_number": "806-894-2796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCILROY",
        "first_name": "LARRY",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-11",
        "last_updated": "2012-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "5763 DC",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "8G5930",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1574915-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Levelland, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2012; 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.