Four-Ten Enterprise, LLC
NPI 1619497401ActiveOrganization· Chiropractor· Tyler, TX
Chiropractor in Tyler, Texas, registered in NPPES in June 2017. The authorized official on file is Jimmy Brian Sullivan, DC, Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1619497401 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jun 22, 2017 |
| Last updated in NPPES | Jan 17, 2023 |
| Certified by provider | Jan 17, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Chiropractor Primary | 111N00000X | 12808 | TX |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (TX) |
|---|
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