Rhodes Chiropractic PC
Organization Active NPI Chiropractor · Davis, OK
NPI 1104915438 · NPPES record last updated Oct 6, 2011
Key facts
- NPI
- 1104915438
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- License
- 2669 (OK)
- Legal business name
- RHODES CHIROPRACTIC PC
- Practice address
- 109 W Main St
Suite C
Davis, OK 73030-1775 - Phone
- (580) 369-3600
- Fax
- (580) 369-3728
- NPI assigned
- Oct 12, 2006
- Organization subpart
- No
Authorized official
- Name
- Dr. James P Rhodes II, DC
- Title
- Owner/Doctor
- Phone
- (580) 369-3600
Practitioners 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OK
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20060119000228 | OK | Part B Supplier - Clinic/Group Practice | 5294759049 |
Receives reassigned benefits from 1 practitioner Practice locations: Davis, OK |
National Provider Directory
Locations
113 W Main St
Ste C
Davis, OK 73030
Phone (580) 369-2325
109 W Main St
Ste C
Davis, OK 73030
Phone (580) 369-3600
502 E Main St
Davis, OK 73030
Phone (580) 369-3600
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | 2669 | OK | Yes |
Addresses
Primary practice location
109 W Main St
Suite C
Davis, OK 73030-1775
Mailing address
109 W Main St
Suite C
Davis, OK 73030-1775
Phone (580) 369-3600
NPI Registry JSON
{
"created_epoch": "1160611200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1317859200000",
"number": "1104915438",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "109 W MAIN ST",
"address_2": "SUITE C",
"city": "DAVIS",
"state": "OK",
"postal_code": "730301775",
"telephone_number": "580-369-3600",
"fax_number": "580-369-3728"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "109 W MAIN ST",
"address_2": "SUITE C",
"city": "DAVIS",
"state": "OK",
"postal_code": "730301775",
"telephone_number": "580-369-3600",
"fax_number": "580-369-3728"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "RHODES CHIROPRACTIC PC",
"organizational_subpart": "NO",
"enumeration_date": "2006-10-12",
"last_updated": "2011-10-06",
"status": "A",
"authorized_official_last_name": "RHODES",
"authorized_official_first_name": "JAMES",
"authorized_official_middle_name": "P",
"authorized_official_title_or_position": "OWNER/DOCTOR",
"authorized_official_telephone_number": "580-369-3600",
"authorized_official_name_prefix": "Dr.",
"authorized_official_name_suffix": "II",
"authorized_official_credential": "DC"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Chiropractor",
"state": "OK",
"license": "2669",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Davis, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 6, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.