NPIMap

Organization Active NPI

Quitman Health Services, PLLC

Doing business as Quitman Chiropractic and Acupuncture

  • Physical Therapist
  • Quitman, TX
National Provider Identifier
1902032402
Registry record updated Dec 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
QUITMAN HEALTH SERVICES, PLLC
Doing business as
Quitman Chiropractic and Acupuncture
Practice address
1018 E. Goode St., Suite 102
Quitman, TX 75783-2563
Phone
(903) 763-4404
Fax
(903) 763-2550
NPI assigned
Jun 10, 2009
Last updated
Dec 19, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2024

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

Authorized official

Name
Dr. John Derek Wisdom, D.C.NPI 1942359658
Title
President
Phone
(903) 763-4404

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X NU
Physical Therapist 225100000X NU Primary
Occupational Therapist 225X00000X NU
Speech-Language Pathologist 235Z00000X NU

Addresses

Primary practice location

1018 E. Goode St., Suite 102
Quitman, TX 75783-2563

Mailing address

1018 E. Goode St., Suite 102
Quitman, TX 75783
Phone (903) 763-4404

Other names 1

  • Quitman Chiropractic and Acupuncture Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130523000026 TX Part B Supplier - Clinic/Group Practice 6800034331 Receives reassigned benefits from 5 practitioners
Practice locations: Quitman, TX

National Provider Directory

National Provider Directory

Locations

1018 E Goode St
#102
Quitman, TX 75783
Phone (903) 763-4404

606 E Goode St
Ste 400
Quitman, TX 75783
Phone (903) 763-4404

Practitioners & affiliated clinicians

Practitioners 5

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": "1244592000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734566400000",
    "number": "1902032402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1018 E. GOODE ST., SUITE 102",
            "city": "QUITMAN",
            "state": "TX",
            "postal_code": "75783",
            "telephone_number": "903-763-4404",
            "fax_number": "903-763-2550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1018 E. GOODE ST., SUITE 102",
            "city": "QUITMAN",
            "state": "TX",
            "postal_code": "757832563",
            "telephone_number": "903-763-4404",
            "fax_number": "903-763-2550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUITMAN HEALTH SERVICES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-10",
        "last_updated": "2024-12-19",
        "certification_date": "2024-12-19",
        "status": "A",
        "authorized_official_last_name": "WISDOM",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "DEREK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "903-763-4404",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Quitman Chiropractic and Acupuncture",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Quitman Chiropractic and Acupuncture",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Quitman, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2024; 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.