Shannon Renae Gulbranson, D.C. – Chiropractor

Key facts

NPI: 1497965057
Entity type: Individual (NPI type 1)
Primary specialty: Chiropractor 111N00000X
License: 3737 (OK)
Practice address: 1335 E 11TH St Ste a
Tulsa, OK 74120-4634
Phone: (918) 005-4452
NPI assigned: May 23, 2007
Sex: Female
Sole proprietor: No

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.

Ctca Physicans Group of Oklahoma, Inc Specialist · Tulsa, OK · NPI 1053309591

NPD (past)

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD): Yes

State licenses

License	State	Type	Specialty
3737	OK	MD	Chiropractor

Practice roles

Organization	Specialty	Status	New patients
Ctca Physicans Group of Oklahoma, Inc		Past	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Chiropractor	111N00000X	3737	OK	Yes

Addresses

Primary practice location

1335 E 11TH St Ste a
Tulsa, OK 74120-4634

Mailing address

1335 E 11TH St Ste a
Tulsa, OK 74120-4634
Phone (918) 500-4452

Other names

Dr. Shannon Renae Subramaniam Former name

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on May 7, 2024.

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715040000000",
    "number": "1497965057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1335 E 11TH ST STE A",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741204634",
            "telephone_number": "918-500-4452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1335 E 11TH ST STE A",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741204634",
            "telephone_number": "918-005-4452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GULBRANSON",
        "first_name": "SHANNON",
        "middle_name": "RENAE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-23",
        "last_updated": "2024-05-07",
        "certification_date": "2024-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OK",
            "license": "3737",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "SUBRAMANIAM",
            "middle_name": "RENAE",
            "prefix": "DR.",
            "credential": "DC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Tulsa, OK

All providers in Tulsa, OK · Chiropractor in Oklahoma

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 7, 2024. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.