Organization Active NPI

Semcresac PLLC

  • Chiropractor
  • Bartlesville, OK
National Provider Identifier
1083997902
Registry record updated Mar 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3166 Issued in OK
Legal business name
SEMCRESAC PLLC
Practice address
2523 SE Washington Blvd
Bartlesville, OK 74006-7613
Phone
(918) 333-3363
Fax
(918) 333-5539
NPI assigned
Sep 27, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2025

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

Authorized official

Name
Tracy Owen Russell, D.C.NPI 1316010572
Title
Owner
Phone
(918) 333-3363

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 3166 OK Primary

Addresses

Primary practice location

2523 SE Washington Blvd
Bartlesville, OK 74006-7613

Mailing address

2523 SE Washington Blvd
Bartlesville, OK 74006-7613
Phone (918) 333-3363

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110930000407 OK Part B Supplier - Clinic/Group Practice 6002088739 Receives reassigned benefits from 1 practitioner
Practice locations: Bartlesville, OK

National Provider Directory

National Provider Directory

Locations

2523 SE Washington Blvd
Bartlesville, OK 74006
Phone (918) 333-3363

Practitioners & affiliated clinicians

Practitioners 1

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": "1317081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740960000000",
    "number": "1083997902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2523 SE WASHINGTON BLVD",
            "city": "BARTLESVILLE",
            "state": "OK",
            "postal_code": "740067613",
            "telephone_number": "918-333-3363",
            "fax_number": "918-333-5539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2523 SE WASHINGTON BLVD",
            "city": "BARTLESVILLE",
            "state": "OK",
            "postal_code": "740067613",
            "telephone_number": "918-333-3363",
            "fax_number": "918-333-5539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEMCRESAC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-27",
        "last_updated": "2025-03-03",
        "certification_date": "2025-03-03",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "TRACY",
        "authorized_official_middle_name": "OWEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "918-333-3363",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "OK",
            "license": "3166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bartlesville, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2025; 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.