John Bradley Eitzen, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

3805 Issued in OK

Practice address

523 S Independence St
Enid, OK 73701-5631

Phone

(580) 237-5007

Fax

(580) 234-6851

NPI assigned

Oct 11, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Specialty

Chiropractic

Education

Cleveland Chiropractic College - Kansas City, 2006

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Eitzen Chiropractic PLLC

  • Clinic/Center
  • Enid, OK
  • NPI 1902942048
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543449600000",
    "number": "1215026273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 W BROADWAY",
            "city": "FAIRVIEW",
            "state": "OK",
            "postal_code": "737372009",
            "telephone_number": "580-227-4200",
            "fax_number": "580-234-6851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "523 S INDEPENDENCE ST",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737015631",
            "telephone_number": "580-237-5007",
            "fax_number": "580-234-6851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EITZEN",
        "first_name": "JOHN",
        "middle_name": "BRADLEY",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-11",
        "last_updated": "2018-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OK",
            "license": "3805",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristina Ann Ediger, RPT
• Audrea Edwards
• Sirfreebird Edwards
• Jean Gabriel Egbuna, MD
• Eitzen Chiropractic PLLC
• Colin Hill Eliot, D.D.S.
• Elite RN PC
• Elizabeth a Chaloupek DDS, PC
• Elizabeth Ellis
• Stacy Luann Ellis, PA

• Chiropractor in Enid, OK
• Providers in Enid, OK by specialty
• Chiropractor in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.