Individual provider Active NPI

Christopher Ronald Blair, D.C.

  • Occupational Health Chiropractor
  • Waco, TX
National Provider Identifier
1821159351
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Health ChiropractorTaxonomy code 111NX0100X
License
8124 Issued in TX
Practice address
415 Lake Air Dr
Waco, TX 76710-5837
Phone
(254) 751-1606
Fax
(254) 772-6118
NPI assigned
Dec 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Health Chiropractor 111NX0100X 8124 TX Primary

Addresses

Primary practice location

415 Lake Air Dr
Waco, TX 76710-5837

Mailing address

415 Lake Air Dr
Waco, TX 76710-5837
Phone (254) 751-1606

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200423001178 TX Practitioner - Chiropractic 6305276833 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8124TXMDOccupational Health Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Imed Physician Network, Inc. CurrentSince Sep 1, 2024 Accepting new patients
Allied Multicare Centers LTD. Past Accepting new patients

Locations

8100 John W Carpenter Fwy
Ste 150
Dallas, TX 75247
Phone (972) 672-4895

2700 W Pleasant Run Rd
Ste 370
Lancaster, TX 75146
Phone (469) 206-4515

2700 W Pleasant Run Rd
Ste 340
Lancaster, TX 75146
Phone (469) 206-4515

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1821159351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 LAKE AIR DR",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767105837",
            "telephone_number": "254-751-1606",
            "fax_number": "254-772-6118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 LAKE AIR DR",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767105837",
            "telephone_number": "254-751-1606",
            "fax_number": "254-772-6118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAIR",
        "first_name": "CHRISTOPHER",
        "middle_name": "RONALD",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NX0100X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Occupational Health",
            "state": "TX",
            "license": "8124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waco, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.