NPIMap

Organization Active NPI

Sandstone Chiropractic Magnolia, PLLC

  • Chiropractor
  • Magnolla, TX
National Provider Identifier
1861813438
Registry record updated Dec 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
8344 Issued in TX
Legal business name
SANDSTONE CHIROPRACTIC MAGNOLIA, PLLC
Practice address
6875 FM 1488
Suite 1300
Magnolla, TX 77354
Phone
(281) 789-7586
Fax
(281) 789-7396
NPI assigned
Dec 26, 2013
Last updated
Dec 26, 2013By the provider in NPPES
Organization subpart
Yes
Parent organization
SANDSTONE CHIROPRACTIC, PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 26, 2013

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

Authorized official

Name
Tony W. Deramus, DCNPI 1750494985
Title
Chiropractor/Owner
Phone
(936) 582-0404

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
Chiropractor 111N00000X 8344 TX Primary

Addresses

Primary practice location

6875 FM 1488
Suite 1300
Magnolla, TX 77354

Mailing address

6875 FM 1488
Suite 1300
Magnolla, TX 77354
Phone (281) 789-7586

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140217000411 TX Part B Supplier - Clinic/Group Practice 5092944066 Receives reassigned benefits from 2 practitioners
Practice locations: Magnolia, TX

National Provider Directory

National Provider Directory
Part of
Sandstone Chiropratic PA

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

6875 FM 1488 Rd
Ste 1300
Magnolia, TX 77354
Phone (281) 789-7586

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1388016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1388016000000",
    "number": "1861813438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6875 FM 1488",
            "address_2": "SUITE 1300",
            "city": "MAGNOLLA",
            "state": "TX",
            "postal_code": "77354",
            "telephone_number": "281-789-7586",
            "fax_number": "281-789-7396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6875 FM 1488",
            "address_2": "SUITE 1300",
            "city": "MAGNOLLA",
            "state": "TX",
            "postal_code": "77354",
            "telephone_number": "281-789-7586",
            "fax_number": "281-789-7396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANDSTONE CHIROPRACTIC MAGNOLIA, PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SANDSTONE CHIROPRACTIC, PA",
        "enumeration_date": "2013-12-26",
        "last_updated": "2013-12-26",
        "status": "A",
        "authorized_official_last_name": "DERAMUS",
        "authorized_official_first_name": "TONY",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "CHIROPRACTOR/OWNER",
        "authorized_official_telephone_number": "936-582-0404",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "8344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2013; 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.