Active NPI
Riley Powell, D.C.
- Chiropractor
- Tulsa, OK
National Provider Identifier
1326088683
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 3679
- Practice address
- 2241 E Skelly Dr Ste 105
Tulsa, OK 74105-5941 - Phone
- (918) 477-7909
- Fax
- (918) 477-7086
- NPI assigned
- Jun 7, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 3679 | OK | Primary |
Addresses
Primary practice location
2241 E Skelly Dr Ste 105
Tulsa, OK 74105-5941
Mailing address
2241 E Skelly Dr Ste 105
Tulsa, OK 74105-5941
Phone (918) 477-7909
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200031330 A | Medicaid | OK |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OK
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040622000819 | OK | Practitioner - Chiropractic | 1557346764 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3679 | OK | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149638400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1708646400000",
"number": "1326088683",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2241 E SKELLY DR STE 105",
"city": "TULSA",
"state": "OK",
"postal_code": "741055941",
"telephone_number": "918-477-7909",
"fax_number": "918-477-7086"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2241 E SKELLY DR STE 105",
"city": "TULSA",
"state": "OK",
"postal_code": "741055941",
"telephone_number": "918-477-7909",
"fax_number": "918-477-7086"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POWELL",
"first_name": "RILEY",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-07",
"last_updated": "2024-02-23",
"certification_date": "2024-02-23",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "OK",
"license": "3679",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200031330 A",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Tulsa, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2024; 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.