Individual provider Active NPI

Martin Chance Shearwood, D.C.

  • Chiropractor
  • Stigler, OK
National Provider Identifier
1285233114
Registry record updated Nov 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4375 Issued in OK
Practice address
909 W Main St
Stigler, OK 74462-2341
Phone
(918) 967-3900
Fax
(918) 967-3908
NPI assigned
Oct 21, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4375 OK Primary

Addresses

Primary practice location

909 W Main St
Stigler, OK 74462-2341

Mailing address

909 W Main St
Stigler, OK 74462-2341
Phone (918) 967-3900

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210624001248 OK Practitioner - Chiropractic 6204237530 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2115 S Hwy 69
Wagoner, OK 74467-9310
Phone (918) 201-4330

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4375OKMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
MC Chiropractic Clinic Chiropractor CurrentSince Oct 1, 2023 Accepting new patients
Shearwood Chiropractic Clinic Inc Chiropractor CurrentSince Jun 18, 2021 Accepting new patients

Locations

909 W Main St
Stigler, OK 74462
Phone (918) 967-3900

2115 S Highway 69
Wagoner, OK 74467
Phone (918) 201-4330

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1603238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605052800000",
    "number": "1285233114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 W MAIN ST",
            "city": "STIGLER",
            "state": "OK",
            "postal_code": "744622341",
            "telephone_number": "918-967-3900",
            "fax_number": "918-967-3908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 W MAIN ST",
            "city": "STIGLER",
            "state": "OK",
            "postal_code": "744622341",
            "telephone_number": "918-967-3900",
            "fax_number": "918-967-3908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEARWOOD",
        "first_name": "MARTIN",
        "middle_name": "CHANCE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-10-21",
        "last_updated": "2020-11-11",
        "certification_date": "2020-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OK",
            "license": "4375",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stigler, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2020; 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.