Organization Active NPI

Thrive Chiropractic Group 3 LLC

  • Chiropractor
  • Edmond, OK
National Provider Identifier
1154948073
Registry record updated Jul 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
THRIVE CHIROPRACTIC GROUP 3 LLC
Practice address
1201 NW 178TH St Ste 119
Edmond, OK 73012-4280
Phone
(405) 604-5295
Fax
(405) 604-5297
NPI assigned
Jun 26, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2020

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

Authorized official

Name
James Tyler Pertree
Title
Owner
Phone
(405) 604-5295

Specialties & licenses 1

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

Addresses

Primary practice location

1201 NW 178TH St Ste 119
Edmond, OK 73012-4280

Mailing address

8013 S Western Ave Ste a
Oklahoma City, OK 73139-2537
Phone (405) 604-5295

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200811000350 OK Part B Supplier - Clinic/Group Practice 1759706518 Receives reassigned benefits from 1 practitioner
Practice locations: Edmond, OK

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

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": "1593129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595980800000",
    "number": "1154948073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8013 S WESTERN AVE STE A",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731392537",
            "telephone_number": "405-604-5295",
            "fax_number": "405-604-5297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 NW 178TH ST STE 119",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730124280",
            "telephone_number": "405-604-5295",
            "fax_number": "405-604-5297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THRIVE CHIROPRACTIC GROUP 3 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-26",
        "last_updated": "2020-07-29",
        "certification_date": "2020-07-29",
        "status": "A",
        "authorized_official_last_name": "PERTREE",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "TYLER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "405-604-5295"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmond, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2020; 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.