Organization Active NPI

Dr Carla Harris Family Chiropractic, PLLC

  • Chiropractor
  • Jenks, OK
National Provider Identifier
1538720693
Registry record updated Jun 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
DR CARLA HARRIS FAMILY CHIROPRACTIC, PLLC
Practice address
421 W Main St
Jenks, OK 74037-3748
Phone
(918) 519-8435
NPI assigned
Jun 27, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2019

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

Authorized official

Name
Dr. Carla Jean Hoelting Harris, DC
Title
President
Phone
(918) 519-8435

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

421 W Main St
Jenks, OK 74037-3748

Mailing address

PO Box 400
Jenks, OK 74037-0400
Phone (918) 519-8435

Other names 1

  • Harris Chiropractic Clinic Former legal business name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address drcharris4kids@att.net Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191022001503 OK Part B Supplier - Clinic/Group Practice 0446582621 Receives reassigned benefits from 1 practitioner
Practice locations: Jenks, OK

National Provider Directory

National Provider Directory

Locations

421 W Main St
Jenks, OK 74037
Phone (918) 519-8435

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1561593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1561593600000",
    "number": "1538720693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 400",
            "city": "JENKS",
            "state": "OK",
            "postal_code": "740370400",
            "telephone_number": "918-519-8435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 W MAIN ST",
            "city": "JENKS",
            "state": "OK",
            "postal_code": "740373748",
            "telephone_number": "918-519-8435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR CARLA HARRIS FAMILY CHIROPRACTIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-27",
        "last_updated": "2019-06-27",
        "status": "A",
        "authorized_official_last_name": "HOELTING HARRIS",
        "authorized_official_first_name": "CARLA",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "918-519-8435",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "drcharris4kids@att.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "421 W Main St",
            "city": "Jenks",
            "state": "OK",
            "country_code": "US",
            "postal_code": "740373748",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Harris Chiropractic Clinic",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Jenks, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2019; 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.