Organization Active NPI

Family Care Chiropractic Clinic, P.C.

  • Chiropractor
  • Rockwall, TX
National Provider Identifier
1881711042
Registry record updated Dec 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4465 Issued in TX
Legal business name
FAMILY CARE CHIROPRACTIC CLINIC, P.C.
Practice address
316 S Goliad St Ste 111
Rockwall, TX 75087-3761
Phone
(972) 771-9448
Fax
(972) 771-8393
NPI assigned
Mar 23, 2007
Last updated
Dec 8, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2011

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

Authorized official

Name
Dr. Charles B Keith Jr., D.C.NPI 1265472369
Title
President
Phone
(972) 771-9448

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 4465 TX Primary

Addresses

Primary practice location

316 S Goliad St Ste 111
Rockwall, TX 75087-3761

Mailing address

316 S Goliad St Ste 111
Rockwall, TX 75087-3761
Phone (972) 771-9448

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120313000459 TX Part B Supplier - Clinic/Group Practice 5991964884 Receives reassigned benefits from 1 practitioner
Practice locations: Rockwall, TX

National Provider Directory

National Provider Directory

Locations

316 S Goliad St
Ste 111
Rockwall, TX 75087
Phone (972) 771-9448

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323302400000",
    "number": "1881711042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "316 S GOLIAD ST STE 111",
            "city": "ROCKWALL",
            "state": "TX",
            "postal_code": "750873761",
            "telephone_number": "972-771-9448",
            "fax_number": "972-771-8393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 S GOLIAD ST STE 111",
            "city": "ROCKWALL",
            "state": "TX",
            "postal_code": "750873761",
            "telephone_number": "972-771-9448",
            "fax_number": "972-771-8393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY CARE CHIROPRACTIC CLINIC, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-23",
        "last_updated": "2011-12-08",
        "status": "A",
        "authorized_official_last_name": "KEITH",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "972-771-9448",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "4465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockwall, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2011; 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.