Organization Active NPI

Gunther Chiropractic, PLLC

Doing business as Active Life Chiropractic

  • Chiropractor
  • Broken Arrow, OK
National Provider Identifier
1548644420
Registry record updated Jul 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
GUNTHER CHIROPRACTIC, PLLC
Doing business as
Active Life Chiropractic
Practice address
2518 E Kenosha St
Broken Arrow, OK 74014-6712
Phone
(918) 286-2729
Fax
(918) 286-0651
NPI assigned
Jul 10, 2015
Last updated
Jul 10, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2015

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

Authorized official

Name
Dr. Andrew James Gunther, D.C.NPI 1144645318
Title
Chiropractor
Phone
(517) 303-9780

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X Primary
Massage Therapist 225700000X

Addresses

Primary practice location

2518 E Kenosha St
Broken Arrow, OK 74014-6712

Mailing address

2518 E Kenosha St
Broken Arrow, OK 74014-6712
Phone (918) 286-2729

Other names 1

  • Active Life Chiropractic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160112003119 OK Part B Supplier - Clinic/Group Practice 0446552129 Receives reassigned benefits from 1 practitioner
Practice locations: Broken Arrow, OK

National Provider Directory

National Provider Directory

Locations

2518 E Kenosha St
Broken Arrow, OK 74014
Phone (918) 286-2729

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1436486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436486400000",
    "number": "1548644420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2518 E KENOSHA ST",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740146712",
            "telephone_number": "918-286-2729",
            "fax_number": "918-286-0651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2518 E KENOSHA ST",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740146712",
            "telephone_number": "918-286-2729",
            "fax_number": "918-286-0651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUNTHER CHIROPRACTIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-10",
        "last_updated": "2015-07-10",
        "status": "A",
        "authorized_official_last_name": "GUNTHER",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "517-303-9780",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Active Life Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Broken Arrow, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2015; 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.