Organization Active NPI

Bratcher Injury & Wellness Center, P.a.

  • Rehabilitation Chiropractor
  • Tyler, TX
National Provider Identifier
1891840666
Registry record updated Sep 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation ChiropractorTaxonomy code 111NR0400X
Legal business name
BRATCHER INJURY & WELLNESS CENTER, P.A.
Practice address
2140 W. Grande Blvd.
Suite a
Tyler, TX 75703
Phone
(903) 561-6676
Fax
(903) 561-7071
NPI assigned
Jan 24, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2010

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

Authorized official

Name
Dr. Luther Burbank Bratcher, D.C.NPI 1326085036
Title
Owner
Phone
(903) 561-6676

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
Rehabilitation ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111NR0400X Primary

Addresses

Primary practice location

2140 W. Grande Blvd.
Suite a
Tyler, TX 75703

Mailing address

2140 W. Grande Blvd.
Suite a
Tyler, TX 75703
Phone (903) 561-6676

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200325000760 TX Part B Supplier - Clinic/Group Practice 0547698573 Receives reassigned benefits from 2 practitioners
Practice locations: Tyler, TX

National Provider Directory

National Provider Directory

Locations

2210 W Grande Blvd
Tyler, TX 75703
Phone (903) 561-5757

Practitioners & affiliated clinicians

Practitioners 2

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": "1169596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1283385600000",
    "number": "1891840666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2140 W. GRANDE BLVD.",
            "address_2": "SUITE A",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "75703",
            "telephone_number": "903-561-6676",
            "fax_number": "903-561-7071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2140 W. GRANDE BLVD.",
            "address_2": "SUITE A",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "75703",
            "telephone_number": "903-561-6676",
            "fax_number": "903-561-7071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRATCHER INJURY & WELLNESS CENTER, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-24",
        "last_updated": "2010-09-02",
        "status": "A",
        "authorized_official_last_name": "BRATCHER",
        "authorized_official_first_name": "LUTHER",
        "authorized_official_middle_name": "BURBANK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "903-561-6676",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2010; 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.