Individual provider Active NPI

Paul Kasishke II, D.C.

  • Chiropractor
  • Tulsa, OK
National Provider Identifier
1437609062
Registry record updated Oct 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4234 Issued in OK
Practice address
11031 S Memorial Dr
Tulsa, OK 74133-7357
Phone
(918) 970-4309
Fax
(918) 970-4396
NPI assigned
Oct 6, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4234 OK Primary

Addresses

Primary practice location

11031 S Memorial Dr
Tulsa, OK 74133-7357

Mailing address

11031 S Memorial Dr
Tulsa, OK 74133-7357
Phone (918) 970-4309

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
4234OKMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1475712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475712000000",
    "number": "1437609062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11031 S MEMORIAL DR",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741337357",
            "telephone_number": "918-970-4309",
            "fax_number": "918-970-4396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11031 S MEMORIAL DR",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741337357",
            "telephone_number": "918-970-4309",
            "fax_number": "918-970-4396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KASISHKE",
        "first_name": "PAUL",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-10-06",
        "last_updated": "2016-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OK",
            "license": "4234",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Oct 6, 2016; 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.