Individual provider Active NPI

Michael Wayne Johnson, D.C

  • Chiropractor
  • Bixby, OK
National Provider Identifier
1306183868
Registry record updated Jan 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4096 Issued in OK
Practice address
7100 E 151St St S
Bixby, OK 74008-4137
Phone
(918) 691-7275
Fax
(918) 366-4460
NPI assigned
Jan 3, 2013
Last updated
Jan 3, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 3, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4096 OK Primary

Addresses

Primary practice location

7100 E 151St St S
Bixby, OK 74008-4137

Mailing address

7100 E 151St St S
Bixby, OK 74008-4137
Phone (918) 691-7275

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130419000292 OK Practitioner - Chiropractic 9638315526 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Brian S. Hicks D.C. Inc PCGroup PAC ID 0042388837, 2 clinicians

Practice addresses (Care Compare)

1020 E Taft Ave
Sapulpa Chiropractic Clinic
Sapulpa, OK 74066-5731
Phone (918) 227-2788

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4096OKMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Brian S. Hicks D.C. Inc P.C. Chiropractor CurrentSince Feb 19, 2013 Accepting new patients
Brian S. Hicks D.C. Inc PC Chiropractor CurrentSince Feb 19, 2013 Accepting new patients

Locations

7100 E 151st St S
Bixby, OK 74008
Phone (918) 366-4461

7100 E 151st St S
#C
Bixby, OK 74008
Phone (918) 366-4461

1020 E Taft Ave
Sapulpa, OK 74066
Phone (918) 227-2788

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": "1357171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357171200000",
    "number": "1306183868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7100 E 151ST ST S",
            "city": "BIXBY",
            "state": "OK",
            "postal_code": "740084137",
            "telephone_number": "918-691-7275",
            "fax_number": "918-366-4460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7100 E 151ST ST S",
            "city": "BIXBY",
            "state": "OK",
            "postal_code": "740084137",
            "telephone_number": "918-691-7275",
            "fax_number": "918-366-4460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MICHAEL",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "D.C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-01-03",
        "last_updated": "2013-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OK",
            "license": "4096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bixby, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2013; 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.