Ballard Chiropractic
Organization Active NPI Clinic/Center · Owasso, OK
NPI 1154744217 · NPPES record last updated Jul 21, 2022
Key facts
- NPI
- 1154744217
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinic/Center 261Q00000X
- License
- 4148 (OK)
- Legal business name
- BALLARD CHIROPRACTIC
- Practice address
- 435 E 2ND Ave
Owasso, OK 74055-3208 - Phone
- (918) 272-8054
- NPI assigned
- Jan 27, 2014
- Organization subpart
- No
Authorized official
- Name
- Dr. Jonathan Ballard, D.C.
- Title
- Doctor
- Phone
- (918) 272-8054
Practitioners 1
-
Jonathan Ballard, D.C.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OK
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20140321001566 | OK | Part B Supplier - Clinic/Group Practice | 9032340732 |
Receives reassigned benefits from 1 practitioner Practice locations: Owasso, OK |
National Provider Directory
Locations
1105 S Eastern Ave
Hominy, OK 74035
Phone (918) 885-9970
8787 N Owasso Expy
Ste M
Owasso, OK 74055
Phone (918) 272-8054
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | 4148 | OK | Yes |
Addresses
Primary practice location
435 E 2ND Ave
Owasso, OK 74055-3208
Mailing address
435 E 2ND Ave
Owasso, OK 74055-3208
Phone (918) 272-8054
Other names
- Complete Care Chiropractic
Other providers in Owasso, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2022. 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.