Organization Active NPI

Childs Chiropractic & Wellness Center P.C.

  • Chiropractor
  • Norman, OK
National Provider Identifier
1043378128
Registry record updated Jun 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3497 Issued in OK
Legal business name
CHILDS CHIROPRACTIC & WELLNESS CENTER P.C.
Practice address
1330 N Interstate Drive
Norman, OK 73072
Phone
(405) 366-9355
Fax
(405) 366-9393
NPI assigned
Dec 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2011

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

Authorized official

Name
Mr. Charles Martin ChildsNPI 1831227057
Title
Chiropractic
Phone
(405) 366-9355

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 3497 OK Primary

Addresses

Primary practice location

1330 N Interstate Drive
Norman, OK 73072

Mailing address

1330 N Interstate Drive
Norman, OK 73072
Phone (405) 366-9355

Other identifiers 1

IdentifierTypeStateIssuer
505-13-8138003OtherOKBLUE CROSS BLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040528000709 OK Part B Supplier - Clinic/Group Practice 4981685591 Receives reassigned benefits from 1 practitioner
Practice locations: Norman, OK

National Provider Directory

National Provider Directory

Locations

1330 N Interstate Dr
Norman, OK 73072
Phone (405) 366-9355

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": "1165190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1306886400000",
    "number": "1043378128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1330 N INTERSTATE DRIVE",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "73072",
            "telephone_number": "405-366-9355",
            "fax_number": "405-366-9393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 N INTERSTATE DRIVE",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "73072",
            "telephone_number": "405-366-9355",
            "fax_number": "405-366-9393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDS CHIROPRACTIC & WELLNESS CENTER P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-04",
        "last_updated": "2011-06-01",
        "status": "A",
        "authorized_official_last_name": "CHILDS",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "MARTIN",
        "authorized_official_title_or_position": "CHIROPRACTIC",
        "authorized_official_telephone_number": "405-366-9355",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "OK",
            "license": "3497",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "505-13-8138003",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norman, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2011; 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.