Organization Active NPI

Nightengale Chiropractic, LLC

  • Chiropractor
  • Edmond, OK
National Provider Identifier
1194243568
Registry record updated Sep 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3897 Issued in OK
Legal business name
NIGHTENGALE CHIROPRACTIC, LLC
Practice address
2616 Covell Village Dr Ste. 120
Edmond, OK 73003
Phone
(405) 323-3373
NPI assigned
Sep 6, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2017

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

Authorized official

Name
Dr. Devin Lee Nightenglae, DC
Title
President
Phone
(405) 323-3373

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 3897 OK Primary

Addresses

Primary practice location

2616 Covell Village Dr Ste. 120
Edmond, OK 73003

Mailing address

PO Box 30225
Edmond, OK 73003
Phone (405) 323-3373

Other identifiers 2

IdentifierTypeStateIssuer
1619129400OtherOKINDIVIDUAL NPI
3897OtherOKSTATE LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171208000954 OK Part B Supplier - Clinic/Group Practice 6002173564 Receives reassigned benefits from 2 practitioners
Practice locations: Edmond, OK

National Provider Directory

National Provider Directory

Locations

2616 Covell Village Dr
Ste 120
Edmond, OK 73003
Phone (405) 323-3373

805 W Covell Rd
Ste 300
Edmond, OK 73003
Phone (405) 471-5565

4025 E Covell Rd
#100
Edmond, OK 73034
Phone (405) 471-5565

Practitioners & affiliated clinicians

Practitioners 3

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": "1504656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1504656000000",
    "number": "1194243568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30225",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "73003",
            "telephone_number": "405-323-3373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2616 COVELL VILLAGE DR STE. 120",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "73003",
            "telephone_number": "405-323-3373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NIGHTENGALE CHIROPRACTIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-06",
        "last_updated": "2017-09-06",
        "status": "A",
        "authorized_official_last_name": "NIGHTENGLAE",
        "authorized_official_first_name": "DEVIN",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "405-323-3373",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "OK",
            "license": "3897",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1619129400",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "3897",
            "state": "OK"
        }
    ],
    "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 Sep 6, 2017; 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.