Green Country Chiropractic LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

4202 Issued in OK

Legal business name

GREEN COUNTRY CHIROPRACTIC LLC

Practice address

11560 N 135TH East Ave Ste 101a
Owasso, OK 74055-5756

Phone

(918) 553-6770

NPI assigned

Sep 4, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Keara Dwyer, DCNPI 1942678115

Title

Owner

Phone

(918) 553-6770

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Keara Dwyer, DC

  • Chiropractor
  • Owasso, OK
  • NPI 1942678115
  Medicare reassignment Care Compare group NPD Authorized official
• Kyle Cavitt, DC

  • Chiropractor
  • Owasso, OK
  • NPI 1932577103
  Medicare reassignment Care Compare group

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1441324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598227200000",
    "number": "1013385285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11560 N 135TH EAST AVE STE 101A",
            "city": "OWASSO",
            "state": "OK",
            "postal_code": "740555756",
            "telephone_number": "918-553-6770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11560 N 135TH EAST AVE STE 101A",
            "city": "OWASSO",
            "state": "OK",
            "postal_code": "740555756",
            "telephone_number": "918-553-6770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREEN COUNTRY CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-04",
        "last_updated": "2020-08-24",
        "certification_date": "2020-08-24",
        "status": "A",
        "authorized_official_last_name": "DWYER",
        "authorized_official_first_name": "KEARA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "918-553-6770",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "OK",
            "license": "4202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Grace Naturale LLC
• Taylor Graffman
• Grass Roots Chiropractic, LLC
• Matthew Philip Gray, DDS
• Michael Gray
• Green Country Emergency Physicians Group of Owasso PLLC
• Amanda Green
• Anna Marie Green, NP
• Megan Green
• Russell John Green, MD

• Chiropractor in Owasso, OK
• Providers in Owasso, OK by specialty
• Chiropractor in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2020; 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.