Individual provider Active NPI

Nicholas Andrew Bagnaro, D.C.

  • Chiropractor
  • Tulsa, OK
National Provider Identifier
1669597605
Registry record updated Dec 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3666 Issued in OK
Practice address
10020 S. Mingo Rd
Ste a
Tulsa, OK 74133
Phone
(918) 991-5427
Fax
(425) 881-6220
NPI assigned
Mar 20, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH00034255 WA
Chiropractor 111N00000X 3666 OK Primary

Addresses

Primary practice location

10020 S. Mingo Rd
Ste a
Tulsa, OK 74133

Mailing address

7122 S. Sheridan Rd
Suite 2-174
Tulsa, OK 74133
Phone (918) 991-5427

Other identifiers 1

IdentifierTypeStateIssuer
0178466OtherWALABOR AND INDUSTRIES

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

State licenses

LicenseStateTypeSpecialty
CH00034255WAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Health and Stability Spinal Care Chiropractor Past Accepting new patients
Redmond Spinal Care, P.C. Chiropractor PastSince Sep 12, 2003 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292889600000",
    "number": "1669597605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7122 S. SHERIDAN RD",
            "address_2": "SUITE 2-174",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "74133",
            "telephone_number": "918-991-5427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10020 S. MINGO RD",
            "address_2": "STE A",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "74133",
            "telephone_number": "918-991-5427",
            "fax_number": "425-881-6220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAGNARO",
        "first_name": "NICHOLAS",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-20",
        "last_updated": "2010-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00034255",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OK",
            "license": "3666",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR AND INDUSTRIES",
            "identifier": "0178466",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 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.