Active NPI
Darryl Dodd Gregerson, DC
- Chiropractor
- Broken Arrow, OK
National Provider Identifier
1669587077
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 3878
- Practice address
- 2518 E Kenosha St
Broken Arrow, OK 74014-6712 - Phone
- (918) 286-2729
- Fax
- (918) 286-0651
- NPI assigned
- Aug 19, 2006
- Last updated
- Jul 22, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 3878 | OK | Primary |
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 identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 46813 | Other | IA | BLUE CROSS/BLUE SHIELD |
| 2118786 | Medicaid | IA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gregerson Chiropractic PC | Chiropractor | Past | Accepting new patients |
| Natural Health & Chiropractic Center PC | Chiropractor | Past | Accepting new patients |
| Chiropractic Health Care Associates P.C. | Chiropractor | Past | Accepting new patients |
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155945600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1216684800000",
"number": "1669587077",
"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": {
"last_name": "GREGERSON",
"first_name": "DARRYL",
"middle_name": "DODD",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-19",
"last_updated": "2008-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "OK",
"license": "3878",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS/BLUE SHIELD",
"identifier": "46813",
"state": "IA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2118786",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}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 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.