NPIMap

Organization Active NPI

Javersak Chiropractic & Spine Center, Inc PC

  • Chiropractor
  • McAlester, OK
National Provider Identifier
1649484627
Registry record updated Sep 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3488 Issued in OK
Legal business name
JAVERSAK CHIROPRACTIC & SPINE CENTER, INC PC
Practice address
1501 Wade Watts Ave
McAlester, OK 74501
Phone
(918) 423-1873
Fax
(877) 310-9896
NPI assigned
May 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2010

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

Authorized official

Name
Dr. Shayne Andrew Javersak, BS,DCNPI 1376628297
Title
Owner
Phone
(918) 423-1873

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
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 3488 OK Primary

Addresses

Primary practice location

1501 Wade Watts Ave
McAlester, OK 74501

Mailing address

1501 Wade Watts Ave
McAlester, OK 74501
Phone (918) 423-1873

Other identifiers 2

IdentifierTypeStateIssuer
50390437701OtherOKBLUE CROSS BLUE SHIELD
614305OtherOKACN

National Provider Directory

National Provider Directory

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": "1178668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1284595200000",
    "number": "1649484627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 WADE WATTS AVE",
            "city": "MCALESTER",
            "state": "OK",
            "postal_code": "74501",
            "telephone_number": "918-423-1873",
            "fax_number": "877-310-9896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 WADE WATTS AVE",
            "city": "MCALESTER",
            "state": "OK",
            "postal_code": "74501",
            "telephone_number": "918-423-1873",
            "fax_number": "877-310-9896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAVERSAK CHIROPRACTIC & SPINE CENTER, INC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-09",
        "last_updated": "2010-09-16",
        "status": "A",
        "authorized_official_last_name": "JAVERSAK",
        "authorized_official_first_name": "SHAYNE",
        "authorized_official_middle_name": "ANDREW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "918-423-1873",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "BS,DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "OK",
            "license": "3488",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "50390437701",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACN",
            "identifier": "614305",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in McAlester, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.