Proactive Chiropractic LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

PROACTIVE CHIROPRACTIC LLC

Practice address

6401 N Interstate Dr Ste 148
Norman, OK 73069-9524

Phone

(405) 801-3665

Fax

(405) 801-3666

NPI assigned

Aug 16, 2022

Organization subpart

No

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

Authorized official

Name

Joseph Glenn, DCNPI 1063859650

Title

Owner

Phone

(405) 801-3665

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Practitioners 4

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

• Joseph Charles Glenn, D.C.

  • Chiropractor
  • Norman, OK
  • NPI 1063859650
  Medicare reassignment NPD Authorized official
• Anthony Greene, D.C.

  • Chiropractor
  • Warr Acres, OK
  • NPI 1669577730
  NPD
• Jacob Edwards, D.C.

  • Chiropractor
  • Moore, OK
  • NPI 1083093678
  NPD (past)
• Gregory Tyler Reading, D.C.

  • Chiropractor
  • Norman, OK
  • NPI 1386096832
  NPD (past)

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

{
    "created_epoch": "1660608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660608000000",
    "number": "1578281663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6401 N INTERSTATE DR STE 148",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730699524",
            "telephone_number": "405-801-3665",
            "fax_number": "405-801-3666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6401 N INTERSTATE DR STE 148",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730699524",
            "telephone_number": "405-801-3665",
            "fax_number": "405-801-3666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROACTIVE CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-16",
        "last_updated": "2022-08-16",
        "certification_date": "2022-08-16",
        "status": "A",
        "authorized_official_last_name": "GLENN",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "405-801-3665",
        "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": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 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.