Tera Egleston Chiropractic Clinic PC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

3469 Issued in OK

Legal business name

TERA EGLESTON CHIROPRACTIC CLINIC PC

Practice address

9100 N Garnett Rd
Suite I
Owasso, OK 74055

Phone

(918) 274-2911

Fax

(918) 274-2911

NPI assigned

Sep 21, 2006

Organization subpart

No

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

Authorized official

Name

Tera Marchelle Egleston, DCNPI 1669508529

Title

Doctor Owner

Phone

(918) 274-2911

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Tera M Egleston DC Former legal business name

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.

• Tera Marchelle Egleston, D.C.

  • Chiropractor
  • Owasso, OK
  • NPI 1669508529
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1508965252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1161",
            "city": "OWASSO",
            "state": "OK",
            "postal_code": "74055",
            "telephone_number": "918-274-2911",
            "fax_number": "918-274-2911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9100 N GARNETT RD",
            "address_2": "SUITE I",
            "city": "OWASSO",
            "state": "OK",
            "postal_code": "74055",
            "telephone_number": "918-274-2911",
            "fax_number": "918-274-2911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TERA EGLESTON CHIROPRACTIC CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "EGLESTON",
        "authorized_official_first_name": "TERA",
        "authorized_official_middle_name": "MARCHELLE",
        "authorized_official_title_or_position": "DOCTOR OWNER",
        "authorized_official_telephone_number": "918-274-2911",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "OK",
            "license": "3469",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "446821654002",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tera M Egleston DC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.