HEALTHSOURCE OF ROANOKE
NPI 1376815597
Chiropractor in Roanoke, TX

Q: What is Collective Chiropractic And Rehab Inc's specialty?

The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.

Active since February 03, 2012

509 E BYRON NELSON BLVD STE A, ROANOKE, TX 76262(817) 490-6200(888) 607-0662 Get Directions Write a Review

NPPES record last updated: March 28, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About Healthsource Of Roanoke NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

HEALTHSOURCE OF ROANOKE (NPI 1376815597) is a healthcare organization registered as a chiropractor in Roanoke, Texas and active in the NPI registry since February 2012. The organization lists Richard L Puckett, Chiropractor/ President, as its authorized official.

NPPES Registry Identity

NPI1376815597

Entity TypeOrganization

Primary Taxonomy111N00000X

Legal Business NameCOLLECTIVE CHIROPRACTIC AND REHAB INC

Location Address509 E BYRON NELSON BLVD STE ARoanoke, TX 76262-6183

Mailing Address509 E Byron Nelson Blvd Ste ARoanoke, TX 76262-6183 · (817) 490-6200 · Fax (682) 831-1200

Phone(817) 490-6200

Fax(888) 607-0662

Organization SubpartNo

Authorized OfficialRichard L PuckettChiropractor/ President · (817) 490-6200

Enumeration DateFebruary 3, 2012

Last NPPES UpdateMarch 28, 2023

NPPES CertifiedMarch 28, 2023

✔ NPI 1376815597 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyChiropractorChiropractic Providers

Taxonomy Code111N00000X

License✔ Licensed in TX · 8264

Definition

A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.

509 E BYRON NELSON BLVD STE A, Roanoke, TX 76262

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Other Names 2

Doing Business AsHealthsource Of Roanoke

Doing Business AsRoanoke Chiropractic & Rehab

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Healthsource Of Roanoke is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by March 31, 2027

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date

StateTexasEnrollment IDO20211228000282Non-DME Part B · Clinic/Group PracticeDue dateMarch 31, 2027

Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Healthsource Of Roanoke, which bills Medicare for the services this clinician delivers.

Clinician (1)

Stephanie Beavers, DC

Chiropractic

NPI 1114307212

524 BUCKSTONE DR.
Saginaw, TX 76179

(682) 553-8144

✔ Accepts Medicare13 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Collective Chiropractic And Rehab Inc's NPI number?

The NPI number for Collective Chiropractic And Rehab Inc is 1376815597. It was assigned to this organization in the NPPES registry on February 3, 2012. The provider is doing business as Healthsource Of Roanoke and Roanoke Chiropractic & Rehab.

Where is Collective Chiropractic And Rehab Inc located?

Collective Chiropractic And Rehab Inc is located at 509 E Byron Nelson Blvd Ste A, Roanoke, TX 76262. The listed phone number is (817) 490-6200.

What is Collective Chiropractic And Rehab Inc's specialty?

The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.

Is Collective Chiropractic And Rehab Inc enrolled in Medicare?

Yes. Collective Chiropractic And Rehab Inc is registered in the Medicare PECOS enrollment system.

When is Collective Chiropractic And Rehab Inc's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Texas, Clinic/Group Practice) is due for revalidation by March 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

How many clinicians bill Medicare through Collective Chiropractic And Rehab Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Chiropractic) reassigns their Medicare billing to Collective Chiropractic And Rehab Inc. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Collective Chiropractic And Rehab Inc was last updated on March 28, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.