Individual provider Active NPI

Zachary Bloom, DC

  • Chiropractor
  • Lawton, OK
National Provider Identifier
1679163950
Registry record updated Jan 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4386 Issued in OK
Practice address
60 NW Sheridan Rd Ste 5
Lawton, OK 73505-6338
Phone
(580) 354-9009
NPI assigned
Jan 21, 2021
Last updated
Jan 21, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4386 OK Primary

Addresses

Primary practice location

60 NW Sheridan Rd Ste 5
Lawton, OK 73505-6338

Mailing address

60 NW Sheridan Rd Ste 5
Lawton, OK 73505-6338
Phone (580) 354-9009

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210316000745 OK Practitioner - Chiropractic 2860808946 Reassigns benefits to 2 organizations
I20250114003237 TX Practitioner - Chiropractic 2860808946 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1001 SW Wilshire Blvd
Burleson, TX 76028-5716
Phone (817) 447-1414

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
16141TXMDProfessional Counselor
4386OKMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Anthony Ferrara Chiropractic PC Chiropractor CurrentSince Jan 24, 2021 Accepting new patients
Quantum Chiropractic Chiropractor CurrentSince Nov 1, 2024 Accepting new patients
Health First Chiropractic Clinic PLLC Chiropractor CurrentSince Feb 1, 2021 Accepting new patients
Inner Sun Chiropractic PC Chiropractor CurrentSince May 11, 2011 Accepting new patients

Locations

60 NW Sheridan Rd
Ste 5
Lawton, OK 73505
Phone (580) 354-9009

401 E Downing St
Tahlequah, OK 74464
Phone (918) 316-3764

1211 W 6th St
Ste 800
Austin, TX 78703
Phone (512) 708-0905

1001 SW Wilshire Blvd
Ste D
Burleson, TX 76028
Phone (817) 447-1414

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1611187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611187200000",
    "number": "1679163950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 NW SHERIDAN RD STE 5",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735056338",
            "telephone_number": "580-354-9009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 NW SHERIDAN RD STE 5",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735056338",
            "telephone_number": "580-354-9009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOOM",
        "first_name": "ZACHARY",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-01-21",
        "last_updated": "2021-01-21",
        "certification_date": "2021-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OK",
            "license": "4386",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawton, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.