Organization Active NPI

Hijazi Chiropractic P.C.

Doing business as Back to Wellness Chiropractic

  • Chiropractor
  • Edmond, OK
National Provider Identifier
1205185303
Registry record updated Mar 31, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3929 Issued in OK
Legal business name
HIJAZI CHIROPRACTIC P.C.
Doing business as
Back to Wellness Chiropractic
Practice address
3560 S Boulevard
Ste 100
Edmond, OK 73013-5413
Phone
(405) 340-0007
Fax
(405) 340-0266
NPI assigned
Sep 5, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2015

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

Authorized official

Name
Dr. Jeff Hijazi, D.C.NPI 1871721787
Title
Owner
Phone
(405) 340-0007

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 3929 OK Primary

Addresses

Primary practice location

3560 S Boulevard
Ste 100
Edmond, OK 73013-5413

Mailing address

3560 S Boulevard
Ste 100
Edmond, OK 73013-5413
Phone (405) 340-0007

Other names 1

  • BACK TO WELLNESS CHIROPRACTIC Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121011000620 OK Part B Supplier - Clinic/Group Practice 7618126491 Receives reassigned benefits from 1 practitioner
Practice locations: Edmond, OK

National Provider Directory

National Provider Directory

Locations

2917 S Bryant Ave
Ste B
Edmond, OK 73013
Phone (405) 340-0007

3560 S Boulevard
Ste 100
Edmond, OK 73013
Phone (405) 340-0007

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": "1346803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427760000000",
    "number": "1205185303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3560 S BOULEVARD",
            "address_2": "STE 100",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730135413",
            "telephone_number": "405-340-0007",
            "fax_number": "405-340-0266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3560 S BOULEVARD",
            "address_2": "STE 100",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730135413",
            "telephone_number": "405-340-0007",
            "fax_number": "405-340-0266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HIJAZI CHIROPRACTIC P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-05",
        "last_updated": "2015-03-31",
        "status": "A",
        "authorized_official_last_name": "HIJAZI",
        "authorized_official_first_name": "JEFF",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "405-340-0007",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "OK",
            "license": "3929",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BACK TO WELLNESS CHIROPRACTIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Mar 31, 2015; 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.