Individual provider Active NPI

Brian Dean Chaffin, DC

  • Chiropractor
  • Shawnee, OK
National Provider Identifier
1114948882
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3724 Issued in OK
Practice address
1505 Airport Dr
Shawnee, OK 74804-4321
Phone
(405) 273-2202
Fax
(405) 273-2292
NPI assigned
Jul 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3724 OK Primary

Addresses

Primary practice location

1505 Airport Dr
Shawnee, OK 74804-4321

Mailing address

1505 Airport Dr
Shawnee, OK 74804-4321
Phone (405) 273-2202

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050324000434 OK Practitioner - Chiropractic 4587614011 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1505 Airport Dr
Shawnee, OK 74804-4321
Phone (405) 273-2202

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3724OKMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Brian Chaffin PLLC Chiropractor CurrentSince Dec 30, 2004 Accepting new patients

Locations

1505 Airport Dr
Shawnee, OK 74804
Phone (405) 273-2202

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114948882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1505 AIRPORT DR",
            "city": "SHAWNEE",
            "state": "OK",
            "postal_code": "748044321",
            "telephone_number": "405-273-2202",
            "fax_number": "405-273-2292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 AIRPORT DR",
            "city": "SHAWNEE",
            "state": "OK",
            "postal_code": "748044321",
            "telephone_number": "405-273-2202",
            "fax_number": "405-273-2292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAFFIN",
        "first_name": "BRIAN",
        "middle_name": "DEAN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OK",
            "license": "3724",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shawnee, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.