Organization Active NPI

Freeform Chiropractic Trophy Club LLC

  • Chiropractor
  • Trophy Club, TX
National Provider Identifier
1861025611
Registry record updated Feb 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
FREEFORM CHIROPRACTIC TROPHY CLUB LLC
Practice address
2240 SH 114
Suite 650
Trophy Club, TX 76262
Phone
(817) 308-4309
Fax
(817) 598-1150
NPI assigned
Feb 20, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2020

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

Authorized official

Name
Dr. Carl David McAfee Jr., DCNPI 1457640419
Title
Owner
Phone
(817) 308-4309

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

2240 SH 114
Suite 650
Trophy Club, TX 76262

Mailing address

930 Hilltop Dr Ste 102
Weatherford, TX 76086-5943
Phone (817) 308-4309

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200515001410 TX Part B Supplier - Clinic/Group Practice 3678904190 Receives reassigned benefits from 3 practitioners
Practice locations: Trophy Club, TX

National Provider Directory

National Provider Directory

Locations

2240 E Highway 114
Ste 660
Trophy Club, TX 76262
Phone 239970248412

930 Hilltop Dr
Ste 102
Weatherford, TX 76086
Phone (817) 308-4309

Practitioners & affiliated clinicians

Practitioners 6

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

NPI Registry JSON

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

{
    "created_epoch": "1582156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582156800000",
    "number": "1861025611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "930 HILLTOP DR STE 102",
            "city": "WEATHERFORD",
            "state": "TX",
            "postal_code": "760865943",
            "telephone_number": "817-308-4309",
            "fax_number": "817-598-1150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2240 SH 114",
            "address_2": "SUITE 650",
            "city": "TROPHY CLUB",
            "state": "TX",
            "postal_code": "76262",
            "telephone_number": "817-308-4309",
            "fax_number": "817-598-1150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREEFORM CHIROPRACTIC TROPHY CLUB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-20",
        "last_updated": "2020-02-20",
        "certification_date": "2020-02-20",
        "status": "A",
        "authorized_official_last_name": "MCAFEE",
        "authorized_official_first_name": "CARL",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-308-4309",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Trophy Club, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2020; 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.