Spine Body & Soul Chiropractic LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

SPINE BODY & SOUL CHIROPRACTIC LLC

Practice address

6917 E Highway 37
Tuttle, OK 73089-8582

Phone

(405) 392-5640

NPI assigned

Feb 15, 2022

Organization subpart

No

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

Authorized official

Name

Savannah Polson, DCNPI 1336894716

Title

Owner/DC

Phone

(405) 392-5640

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Savannah Polson, DC

  • Chiropractor
  • Tuttle, OK
  • NPI 1336894716
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1644883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644883200000",
    "number": "1508511981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 479",
            "city": "TUTTLE",
            "state": "OK",
            "postal_code": "730890479",
            "telephone_number": "405-392-5640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6917 E HIGHWAY 37",
            "city": "TUTTLE",
            "state": "OK",
            "postal_code": "730898582",
            "telephone_number": "405-392-5640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPINE BODY & SOUL CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-15",
        "last_updated": "2022-02-15",
        "certification_date": "2022-02-15",
        "status": "A",
        "authorized_official_last_name": "POLSON",
        "authorized_official_first_name": "SAVANNAH",
        "authorized_official_title_or_position": "OWNER/DC",
        "authorized_official_telephone_number": "405-392-5640",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Sue Shay
• Tonna Shoffit, BA SOCIOLOGY
• Ashley Smith, MS.,CCC-SLP
• Thomas Ray Smith Jr.
• Southwest LTC Tuttle LLC
• Mark Daniel Stevens
• Tammy Stone, MS, CCC-SLP
• The Star Pharmacy
• Kelly Lange Torrez
• Tracy Rehabilitative Services, PC

• Chiropractor in Tuttle, OK
• Providers in Tuttle, OK by specialty
• Chiropractor in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.