NPIMap

Organization Active NPI

CCM Chiropractic LLC

  • Chiropractor
  • Locust Grove, OK
National Provider Identifier
1437475282
Registry record updated Apr 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3649 Issued in OK
Legal business name
CCM CHIROPRACTIC LLC
Practice address
413 E Main St
Locust Grove, OK 74352
Phone
(918) 479-2827
NPI assigned
Apr 19, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2010

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

Authorized official

Name
Dr. Clinton C. Moore, D. C.
Title
Chiropractor
Phone
(918) 479-2827

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 3649 OK Primary

Addresses

Primary practice location

413 E Main St
Locust Grove, OK 74352

Mailing address

PO Box 1471
Locust Grove, OK 74352-1471
Phone (918) 479-2827

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1271635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271635200000",
    "number": "1437475282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1471",
            "city": "LOCUST GROVE",
            "state": "OK",
            "postal_code": "743521471",
            "telephone_number": "918-479-2827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "413 E MAIN ST",
            "city": "LOCUST GROVE",
            "state": "OK",
            "postal_code": "74352",
            "telephone_number": "918-479-2827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CCM CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-19",
        "last_updated": "2010-04-19",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "CLINTON",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "918-479-2827",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D. C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "OK",
            "license": "3649",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Locust Grove, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.