Individual provider Active NPI

Ryan Dane Marshall, DC

  • Chiropractor
  • Tulsa, OK
National Provider Identifier
1477560167
Registry record updated Apr 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3720 Issued in OK
Practice address
6703 East 81St Street
Ste E
Tulsa, OK 74133-4157
Phone
(918) 494-0929
Fax
(918) 494-0927
NPI assigned
Aug 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3720 OK Primary

Addresses

Primary practice location

6703 East 81St Street
Ste E
Tulsa, OK 74133-4157

Mailing address

6703 East 81St Street
Ste E
Tulsa, OK 74133-4153
Phone (918) 494-0929

Other identifiers 1

IdentifierTypeStateIssuer
200069340AMedicaidOK

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050215000001 OK Practitioner - Chiropractic 3476504127 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6703 E 81St St
Suite E
Tulsa, OK 74133-4157
Phone (918) 494-0929

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3720OKMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Ryan Marshall PLLC Chiropractor CurrentSince Nov 1, 2004 Accepting new patients

Locations

6703 E 81st St
Ste E
Tulsa, OK 74133
Phone (918) 494-0929

Organizations & group practices 1

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": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303689600000",
    "number": "1477560167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6703 EAST 81ST STREET",
            "address_2": "STE E",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741334153",
            "telephone_number": "918-494-0929",
            "fax_number": "918-494-0927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6703 EAST 81ST STREET",
            "address_2": "STE E",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741334157",
            "telephone_number": "918-494-0929",
            "fax_number": "918-494-0927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "RYAN",
        "middle_name": "DANE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-02",
        "last_updated": "2011-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OK",
            "license": "3720",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200069340A",
            "state": "OK"
        }
    ],
    "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 Apr 25, 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.