Organization Active NPI

Waddell Family Chiropractic

  • Chiropractor
  • Shawnee, OK
National Provider Identifier
1053536904
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3588 Issued in OK
Legal business name
WADDELL FAMILY CHIROPRACTIC
Practice address
2801 N Market Ave
Shawnee, OK 74804-2031
Phone
(405) 878-1340
NPI assigned
Apr 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Chris Waddell, D.C.
Title
President
Phone
(405) 878-1340

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 3588 OK Primary

Addresses

Primary practice location

2801 N Market Ave
Shawnee, OK 74804-2031

Mailing address

2801 N Market Ave
Shawnee, OK 74804-2031

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111019000417 OK Part B Supplier - Clinic/Group Practice 3577735455 Receives reassigned benefits from 2 practitioners
Practice locations: Shawnee, OK

National Provider Directory

National Provider Directory

Locations

120 W MacArthur St
Ste 130
Shawnee, OK 74804
Phone (405) 878-1340

2621 N Broadway Ave
Shawnee, OK 74804
Phone (405) 878-1340

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1053536904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 N MARKET AVE",
            "city": "SHAWNEE",
            "state": "OK",
            "postal_code": "748042031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 N MARKET AVE",
            "city": "SHAWNEE",
            "state": "OK",
            "postal_code": "748042031",
            "telephone_number": "405-878-1340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WADDELL FAMILY CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WADDELL",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "405-878-1340",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "OK",
            "license": "3588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shawnee, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.