Individual provider Active NPI

Brian Roadhouse, D.C.

  • Chiropractor
  • Tulsa, OK
National Provider Identifier
1477559201
Registry record updated Dec 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2353 Issued in OK
Practice address
6565 S Yale Ave
Ste 106
Tulsa, OK 74136-8310
Phone
(918) 481-2770
Fax
(918) 481-2774
NPI assigned
Jun 27, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 30, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2353 OK Primary

Addresses

Primary practice location

6565 S Yale Ave
Ste 106
Tulsa, OK 74136-8310

Mailing address

6565 S Yale Ave
Ste 106
Tulsa, OK 74136-8310
Phone (918) 481-2770

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100830000163 OK Practitioner - Chiropractic 3072637941 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6565 S Yale Ave
Suite 106
Tulsa, OK 74136-8302
Phone (918) 481-2770

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2353OKMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Regeneration Nation LLC CurrentSince Sep 28, 2017 Accepting new patients
Roadhouse Chiropractic LLC Chiropractor CurrentSince May 13, 2013 Accepting new patients
Tulsa Varicose Vein Center LLC PastSince Jun 1, 2022 Accepting new patients
Regeneration Nation Tulsa LLC Chiropractor PastSince Oct 18, 2021 Accepting new patients

Locations

6565 S Yale Ave
Ste 106
Tulsa, OK 74136
Phone (918) 481-2770

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1119830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672358400000",
    "number": "1477559201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6565 S YALE AVE",
            "address_2": "STE 106",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741368310",
            "telephone_number": "918-481-2770",
            "fax_number": "918-481-2774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6565 S YALE AVE",
            "address_2": "STE 106",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741368310",
            "telephone_number": "918-481-2770",
            "fax_number": "918-481-2774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROADHOUSE",
        "first_name": "BRIAN",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-27",
        "last_updated": "2022-12-30",
        "certification_date": "2022-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OK",
            "license": "2353",
            "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 Dec 30, 2022; 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.