Organization Active NPI

Nichols Chiropractic, LLC

  • Chiropractor
  • Jenks, OK
National Provider Identifier
1558727701
Registry record updated Sep 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3981 Issued in OK
Legal business name
NICHOLS CHIROPRACTIC, LLC
Practice address
11462 S Union Ave Ste a
Jenks, OK 74037-6902
Phone
(918) 512-8186
NPI assigned
Jan 4, 2016
Last updated
Sep 26, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2024

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

Authorized official

Name
Dr. Kasey Michelle Nichols, D.C.NPI 1063723849
Title
Chiropractor
Phone
(918) 637-3630

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3981 OK Primary

Addresses

Primary practice location

11462 S Union Ave Ste a
Jenks, OK 74037-6902

Mailing address

11462 S Union Ave Ste a
Jenks, OK 74037-6902
Phone (918) 512-8186

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160519000329 OK Part B Supplier - Clinic/Group Practice 0446549109 Receives reassigned benefits from 1 practitioner
Practice locations: Jenks, OK

National Provider Directory

National Provider Directory

Locations

11462 S Union Ave
Ste A
Jenks, OK 74037
Phone (918) 512-8186

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": "1451865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727308800000",
    "number": "1558727701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11462 S UNION AVE STE A",
            "city": "JENKS",
            "state": "OK",
            "postal_code": "740376902",
            "telephone_number": "918-512-8186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11462 S UNION AVE STE A",
            "city": "JENKS",
            "state": "OK",
            "postal_code": "740376902",
            "telephone_number": "918-512-8186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NICHOLS CHIROPRACTIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-04",
        "last_updated": "2024-09-26",
        "certification_date": "2024-09-26",
        "status": "A",
        "authorized_official_last_name": "NICHOLS",
        "authorized_official_first_name": "KASEY",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "918-637-3630",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OK",
            "license": "3981",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Sep 26, 2024; 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.