Individual provider Active NPI

Rebecca Dawn Smith, D.C.

  • Chiropractor
  • Elk City, OK
National Provider Identifier
1073618195
Registry record updated Feb 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3760 Issued in OK
Practice address
2103 S Main St Ste N
Elk City, OK 73644-9167
Phone
(580) 243-0700
Fax
(580) 243-0771
NPI assigned
Sep 13, 2006
Last updated
Feb 16, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3760 OK Primary

Addresses

Primary practice location

2103 S Main St Ste N
Elk City, OK 73644-9167

Mailing address

2103 S Main St Ste N
PO Box 40
Elk City, OK 73644-9167
Phone (580) 243-0700

Other names 1

  • Dr. Rebecca Dawn Val Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051019000923 OK Practitioner - Chiropractic 7113943150 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2103 S Main St
Suite N
Elk City, OK 73644-9167
Phone (580) 243-0700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3760OKMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Smith Family Chiropractic P.C. Chiropractor CurrentSince Sep 15, 2005 Accepting new patients
Jackson County Memorial Hospital Authority Past Accepting new patients

Locations

2103 S Main St
Ste N
Elk City, OK 73644
Phone (580) 243-0700

419 W 3rd St
Elk City, OK 73644
Phone (580) 243-0700

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329350400000",
    "number": "1073618195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2103 S MAIN ST STE N",
            "address_2": "PO BOX 40",
            "city": "ELK CITY",
            "state": "OK",
            "postal_code": "736449167",
            "telephone_number": "580-243-0700",
            "fax_number": "580-243-0771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2103 S MAIN ST STE N",
            "city": "ELK CITY",
            "state": "OK",
            "postal_code": "736449167",
            "telephone_number": "580-243-0700",
            "fax_number": "580-243-0771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "REBECCA",
        "middle_name": "DAWN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-13",
        "last_updated": "2012-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OK",
            "license": "3760",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REBECCA",
            "last_name": "VAL",
            "middle_name": "DAWN",
            "prefix": "DR.",
            "credential": "D.C.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Elk City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2012; 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.