Organization Active NPI

New Life Chiropractic

  • Chiropractor
  • Seminole, OK
National Provider Identifier
1033555289
Registry record updated May 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3429 Issued in OK
Legal business name
NEW LIFE CHIROPRACTIC
Practice address
304 N Main St
Seminole, OK 74868-3428
Phone
(405) 382-3635
Fax
(405) 382-1037
NPI assigned
May 15, 2013
Last updated
May 15, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 15, 2013

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

Authorized official

Name
Ms. Michelle R Nelson, DONPI 1831316637
Title
Owner
Phone
(405) 382-3635

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 3429 OK Primary

Addresses

Primary practice location

304 N Main St
Seminole, OK 74868-3428

Mailing address

PO Box 1301
Seminole, OK 74818-1301
Phone (405) 382-3635

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171219002793 OK Part B Supplier - Clinic/Group Practice 7618235730 Receives reassigned benefits from 1 practitioner
Practice locations: Seminole, OK

National Provider Directory

National Provider Directory

Locations

219 E Evans Ave
Seminole, OK 74868
Phone (405) 382-3635

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1368576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1368576000000",
    "number": "1033555289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1301",
            "city": "SEMINOLE",
            "state": "OK",
            "postal_code": "748181301",
            "telephone_number": "405-382-3635",
            "fax_number": "405-382-1037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 N MAIN ST",
            "city": "SEMINOLE",
            "state": "OK",
            "postal_code": "748683428",
            "telephone_number": "405-382-3635",
            "fax_number": "405-382-1037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW LIFE CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-15",
        "last_updated": "2013-05-15",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "405-382-3635",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "OK",
            "license": "3429",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seminole, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2013; 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.