Dale Wayne Maynard Jr., D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

3752 Issued in OK

Practice address

5113 SE 15TH St Ste C
Del City, OK 73115-3952

Phone

(405) 601-0700

Fax

(405) 605-5776

NPI assigned

Mar 22, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Specialty

Chiropractic

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

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.

• Mid-del Chiropractic LLC

  • Chiropractor
  • Del City, OK
  • NPI 1679853030
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313366400000",
    "number": "1376669986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5113 SE 15TH ST STE C",
            "city": "DEL CITY",
            "state": "OK",
            "postal_code": "731153952",
            "telephone_number": "405-601-0700",
            "fax_number": "405-605-5776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5113 SE 15TH ST STE C",
            "city": "DEL CITY",
            "state": "OK",
            "postal_code": "731153952",
            "telephone_number": "405-601-0700",
            "fax_number": "405-605-5776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYNARD",
        "first_name": "DALE",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-22",
        "last_updated": "2011-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OK",
            "license": "3752",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "432065001-001",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ericia Lashay Maddox
• Brandi Maestas
• Daniel Marquez
• Carlos Martin
• Dashena L. Mason
• Joan Yvonne McAllister-Williams
• Dustin W McCaslin
• Rashanna Kaye McDaniel
• John D McLaughlin II, M.D.
• Jerry Medlock

• Chiropractor in Del City, OK
• Providers in Del City, OK by specialty
• Chiropractor in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2011; 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.