Active NPI
Jacob Edwards, D.C.
- Chiropractor
- Moore, OK
National Provider Identifier
1083093678
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 4198
- Practice address
- 1008 SW 4TH St Ste 110
Moore, OK 73160-2405 - Phone
- (405) 708-6300
- Fax
- (405) 708-6388
- NPI assigned
- May 28, 2015
- Last updated
- May 8, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 4198 | OK | Primary |
Addresses
Primary practice location
1008 SW 4TH St Ste 110
Moore, OK 73160-2405
Mailing address
1008 SW 4TH St Ste 110
Moore, OK 73160-2405
Phone (405) 708-6300
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OK
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1008 SW 4TH St
Suite 110
Moore, OK 73160-2405
Phone (405) 708-6300
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thrive Chiropractic Group 3 LLC | Chiropractor | Current | Accepting new patients |
| Jce Chiropractic Clinic | Chiropractor | Current | Accepting new patients |
| Proactive Chiropractic LLC | Chiropractor | Past | Accepting new patients |
Locations
1008 SW 4th St
Ste 110
Moore, OK 73160
Phone (405) 708-6300
8013 S Western Ave
Ste A
Oklahoma City, OK 73139
Phone (405) 604-5295
Organizations & group practices 4
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.
-
- Chiropractor
- Edmond, OK
- NPI 1154948073
-
- Chiropractor
- Norman, OK
- NPI 1578281663
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1432771200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1746662400000",
"number": "1083093678",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1008 SW 4TH ST STE 110",
"city": "MOORE",
"state": "OK",
"postal_code": "731602405",
"telephone_number": "405-708-6300",
"fax_number": "405-708-6388"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1008 SW 4TH ST STE 110",
"city": "MOORE",
"state": "OK",
"postal_code": "731602405",
"telephone_number": "405-708-6300",
"fax_number": "405-708-6388"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDWARDS",
"first_name": "JACOB",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-05-28",
"last_updated": "2025-05-08",
"certification_date": "2025-05-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "OK",
"license": "4198",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Moore, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2025; 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.