Tina Marie Southworth, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

3496 Issued in OK

Practice address

519 N 2ND St
Stilwell, OK 74960-2407

Phone

(918) 696-7220

Fax

(918) 696-7479

NPI assigned

Jun 8, 2006

Last updated

Aug 13, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Specialty

Chiropractic

Education

Cleveland Chiropractic College - Kansas City, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Late Night Chiropractic PLLC

  • Chiropractor
  • Stilwell, OK
  • NPI 1407802986
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597276800000",
    "number": "1023058625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 S 2ND ST",
            "city": "STILWELL",
            "state": "OK",
            "postal_code": "749603838",
            "telephone_number": "918-696-7220",
            "fax_number": "918-696-7479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "519 N 2ND ST",
            "city": "STILWELL",
            "state": "OK",
            "postal_code": "749602407",
            "telephone_number": "918-696-7220",
            "fax_number": "918-696-7479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUTHWORTH",
        "first_name": "TINA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-08",
        "last_updated": "2020-08-13",
        "certification_date": "2020-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OK",
            "license": "3496",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lindsay Aaron Smith, D.D.S.
• Kathy Anne Smoot, LSW UNDER SUPERVISIO
• Leonie Snell, DPH
• SNH Opco, LLC (Stilwell Nursing and Rehab)
• Cassandra Dawn Snider, M.S. CCC-SLP
• Rebecca L Sparks, LCSW
• Adam Graymoor Sprankell, M.D.
• Kim Stanford
• Nichole Deann Starr, BHRS
• Stilwell Drug Company LLC (Stilwell Pharmacy)

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.