NPIMap

Organization Active NPI

Dacus Chiropractic PLLC

  • Chiropractor
  • Mansfield, TX
National Provider Identifier
1972741775
Registry record updated Jan 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
11063 Issued in TX
Legal business name
DACUS CHIROPRACTIC PLLC
Practice address
2771 E Broad St Ste 211
Mansfield, TX 76063-9157
Phone
(682) 518-6263
Fax
(682) 325-3733
NPI assigned
Feb 2, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2016

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

Authorized official

Name
Dr. Clinton Keith Dacus, D.C.NPI 1386882314
Title
Chiropractor
Phone
(682) 518-6263

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 11063 TX Primary

Addresses

Primary practice location

2771 E Broad St Ste 211
Mansfield, TX 76063-9157

Mailing address

2771 E Broad St Ste 211
Mansfield, TX 76063-9157
Phone (682) 518-6263

Other names 1

  • True Balance Chiropractic & Physical Therapy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090408000470 TX Part B Supplier - Clinic/Group Practice 7517014509 Receives reassigned benefits from 1 practitioner
Practice locations: Mansfield, TX

National Provider Directory

National Provider Directory

Locations

2500 E Broad St
Ste 106
Mansfield, TX 76063
Phone (682) 518-6263

Practitioners & affiliated clinicians

Practitioners 7

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": "1233532800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1452470400000",
    "number": "1972741775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2771 E BROAD ST STE 211",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760639157",
            "telephone_number": "682-518-6263",
            "fax_number": "682-325-3733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2771 E BROAD ST STE 211",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760639157",
            "telephone_number": "682-518-6263",
            "fax_number": "682-325-3733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DACUS CHIROPRACTIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-02",
        "last_updated": "2016-01-11",
        "status": "A",
        "authorized_official_last_name": "DACUS",
        "authorized_official_first_name": "CLINTON",
        "authorized_official_middle_name": "KEITH",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "682-518-6263",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "11063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "True Balance Chiropractic & Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mansfield, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2016; 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.