Blake Alan Matlock, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

4274 Issued in OK

Practice address

8901 S Santa Fe Ave Ste a
Oklahoma City, OK 73139-8413

Phone

(405) 634-0042

NPI assigned

Jul 12, 2018

Sex

Male

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

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• 405 Chiropractic

  • Chiropractor
  • Oklahoma City, OK
  • NPI 1427521038
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1531353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531353600000",
    "number": "1063998128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8901 S SANTA FE AVE STE A",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731398413",
            "telephone_number": "405-634-0042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8901 S SANTA FE AVE STE A",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731398413",
            "telephone_number": "405-634-0042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATLOCK",
        "first_name": "BLAKE",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-07-12",
        "last_updated": "2018-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OK",
            "license": "4274",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer L Mathis
• Meagan Kaye Mathis, LPC
• Tiphanie S. Mathis, PT
• Trevor Blaine Mathis
• Jennifer Matlock-Boggs, M.ED
• Christopher W Matlock, BA
• Jessica Matlock, LPN
• Keauntae D Matlock
• Shelby Brook Matlock, DPT
• Tara Matlock, LPC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2018; 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.