Late Night Chiropractic PLLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

3496 Issued in OK

Legal business name

LATE NIGHT CHIROPRACTIC PLLC

Practice address

102 W Pine St
Stilwell, OK 74960-2652

Phone

(918) 696-7220

Fax

(918) 696-7479

NPI assigned

May 26, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Tina Marie Southworth, DCNPI 1023058625

Title

Chiropractor

Phone

(918) 696-7220

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tina Marie Southworth, DC

  • Chiropractor
  • Stilwell, OK
  • NPI 1023058625
  Medicare reassignment NPD Authorized official
• Shelbie Nichole Corwin, MT

  • Massage Therapist
  • Stilwell, OK
  • NPI 1720895337
  NPD
• Jody Lynn Dandridge

  • Massage Therapist
  • Stilwell, OK
  • NPI 1568214070
  NPD
• Jordan Matthew Green

  • Massage Therapist
  • Stilwell, OK
  • NPI 1669239117
  NPD

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1407802986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 W PINE ST",
            "city": "STILWELL",
            "state": "OK",
            "postal_code": "749602652",
            "telephone_number": "918-696-7220",
            "fax_number": "918-696-7479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 W PINE ST",
            "city": "STILWELL",
            "state": "OK",
            "postal_code": "749602652",
            "telephone_number": "918-696-7220",
            "fax_number": "918-696-7479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LATE NIGHT CHIROPRACTIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SOUTHWORTH",
        "authorized_official_first_name": "TINA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "918-696-7220",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "OK",
            "license": "3496",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brenda Kincaid
• Megan Nicole Kirk, M.S., CCC-SLP
• Madison Kitchens, PA
• Jennifer Kliest, RDH
• Vikrant Laxman Landge, MD
• Cassie Latimer
• BJ Latta
• Robert Latta
• Stephanie Latta
• Kristy Leatherwood, M.ED.,CCC-SLP

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.

Verify at the official NPI Registry.