Organization Active NPI

Cornerstone Chiropractic LLC

  • Chiropractor
  • Enid, OK
National Provider Identifier
1154859627
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4255 Issued in OK
Legal business name
CORNERSTONE CHIROPRACTIC LLC
Practice address
2510 W Chestnut Ave Ste F
Enid, OK 73703-3902
Phone
(580) 540-3357
Fax
(580) 540-3357
NPI assigned
May 30, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Dr. John Conaway, DCNPI 1518495084
Title
Owner
Phone
(580) 540-3357

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 4255 OK Primary

Addresses

Primary practice location

2510 W Chestnut Ave Ste F
Enid, OK 73703-3902

Mailing address

2510 W Chestnut Ave Ste F
Enid, OK 73703-3902
Phone (580) 540-3357

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170619002209 OK Part B Supplier - Clinic/Group Practice 6002184934 Receives reassigned benefits from 2 practitioners
Practice locations: Enid, OK

National Provider Directory

National Provider Directory

Locations

2510 W Chestnut Ave
Ste F
Enid, OK 73703
Phone (580) 540-3357

Practitioners & affiliated clinicians

Practitioners 2

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": "1496102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1154859627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2510 W CHESTNUT AVE STE F",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737033902",
            "telephone_number": "580-540-3357",
            "fax_number": "580-540-3357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2510 W CHESTNUT AVE STE F",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737033902",
            "telephone_number": "580-540-3357",
            "fax_number": "580-540-3357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORNERSTONE CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-30",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "CONAWAY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "580-540-3357",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "OK",
            "license": "4255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Enid, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.