Organization Active NPI

Arbuckle Chiropractic LLC

  • Chiropractor
  • Sulphur, OK
National Provider Identifier
1124680079
Registry record updated Jul 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
ARBUCKLE CHIROPRACTIC LLC
Practice address
1500 W. 1St St
Sulphur, OK 73086
Phone
(580) 622-5959
Fax
(580) 622-6108
NPI assigned
Jul 1, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2019

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

Authorized official

Name
Dr. Robert Vallandensham, D.C.
Title
Dr.
Phone
(580) 622-5959

Specialties & licenses 1

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

Addresses

Primary practice location

1500 W. 1St St
Sulphur, OK 73086

Mailing address

1500 W. 1St St
Sulphur, OK 73086
Phone (580) 622-5959

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200211002403 OK Part B Supplier - Clinic/Group Practice 6608202692 Receives reassigned benefits from 1 practitioner
Practice locations: Sulphur, OK

National Provider Directory

National Provider Directory

Locations

1500 W 1st St
Sulphur, OK 73086
Phone (580) 622-5959

81 Charles F Cooper Memorial Dr
Sulphur, OK 73086
Phone (580) 622-5959

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": "1561939200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1561939200000",
    "number": "1124680079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 W. 1ST ST",
            "city": "SULPHUR",
            "state": "OK",
            "postal_code": "73086",
            "telephone_number": "580-622-5959",
            "fax_number": "580-622-6108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 W. 1ST ST",
            "city": "SULPHUR",
            "state": "OK",
            "postal_code": "73086",
            "telephone_number": "580-622-5959",
            "fax_number": "580-622-6108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARBUCKLE CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-01",
        "last_updated": "2019-07-01",
        "status": "A",
        "authorized_official_last_name": "VALLANDENSHAM",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "DR.",
        "authorized_official_telephone_number": "580-622-5959",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sulphur, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2019; 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.