HealthSource of Roanoke – Chiropractor, NPI 1376815597

HealthSource of Roanoke is a healthcare provider. based in Roanoke, Texas. specializing in Chiropractor. The organization holds a License No. 8264 (TX). The NPI Number for HealthSource of Roanoke is 1376815597

Main info

Organization
Name
HealthSource of Roanoke
NPI
1376815597
Phone
(817) 490-6200
Address
509 E BYRON NELSON BLVD STE A
Authorized Official
DR. RICHARD L PUCKETT CHIROPRACTOR/ PRESIDENT D.C.
Enumeration Date
3 February 2012
Last Update Date
28 March 2023
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness80
Years active:14State licenses:1Digital endpointsUpdated within 12 months

Provider Addresses for HealthSource of Roanoke

  • 509 E BYRON NELSON BLVD STE A

    ROANOKE, TX 762626183

    Phone: (817) 490-6200

    Fax: (682) 831-1200

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2021-12-28

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20211228000282OClinic/Group PracticeTXTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 76262)

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Reviews

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Frequently asked questions

What federal number belongs to HealthSource of Roanoke?
The federal identifier for HealthSource of Roanoke is NPI 1376815597.
Is HealthSource of Roanoke's enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What kind of provider is HealthSource of Roanoke?
The page reflects Chiropractor for HealthSource of Roanoke. Clinical services aligned with this taxonomy classification.
What location shows for HealthSource of Roanoke?
We surface Roanoke, Texas for HealthSource of Roanoke based on available NPPES addresses.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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