Sallisaw Chiropractic Clinic Inc.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

4028 Issued in OK

Legal business name

SALLISAW CHIROPRACTIC CLINIC INC.

Practice address

502 E Cherokee Ave
Sallisaw, OK 74955-4842

Phone

(918) 775-7100

Fax

(918) 775-7138

NPI assigned

Jun 22, 2011

Last updated

Jun 22, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Matthew Alan Bauer, D.C.NPI 1780976589

Title

Owner

Phone

(918) 775-7100

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Practitioners 1

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.

• Matthew Alan Bauer, D.C.

  • Chiropractor
  • Sallisaw, OK
  • NPI 1780976589
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1308700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308700800000",
    "number": "1053607655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "502 E CHEROKEE AVE",
            "city": "SALLISAW",
            "state": "OK",
            "postal_code": "749554842",
            "telephone_number": "918-775-7100",
            "fax_number": "918-775-7138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 E CHEROKEE AVE",
            "city": "SALLISAW",
            "state": "OK",
            "postal_code": "749554842",
            "telephone_number": "918-775-7100",
            "fax_number": "918-775-7138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SALLISAW CHIROPRACTIC CLINIC INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-22",
        "last_updated": "2011-06-22",
        "status": "A",
        "authorized_official_last_name": "BAUER",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "918-775-7100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OK",
            "license": "4028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Darrin Thomas Ross
• Sherry Lynn Rouse, RN
• Vickie R Rowell
• Natalie Elise Russell, R.D.
• Sallisaw Chiropractic Clinic
• Sallisaw Family Medicine, L.L.C.
• Sallisaw Medical Clinic LLC
• Sallisaw Mental Health LLC
• Sallisaw Pharmacy Inc
• Sallisaw Pharmacy Inc (Sallisaw Pharmacy)

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

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