Mid-del Chiropractic LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

3752 Issued in OK

Legal business name

MID-DEL CHIROPRACTIC LLC

Practice address

5113 SE 15TH St Ste C
Del City, OK 73115-3952

Phone

(405) 601-0700

Fax

(405) 605-5776

NPI assigned

Aug 17, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Dale Wayne Maynard Jr., D.C.NPI 1376669986

Title

Owner

Phone

(405) 601-0700

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Locations

Practitioners 1

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

• Dale Wayne Maynard Jr., D.C.

  • Chiropractor
  • Del City, OK
  • NPI 1376669986
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1313539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1321833600000",
    "number": "1679853030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5113 SE 15TH ST STE C",
            "city": "DEL CITY",
            "state": "OK",
            "postal_code": "731153952",
            "telephone_number": "405-601-0700",
            "fax_number": "405-605-5776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5113 SE 15TH ST STE C",
            "city": "DEL CITY",
            "state": "OK",
            "postal_code": "731153952",
            "telephone_number": "405-601-0700",
            "fax_number": "405-605-5776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID-DEL CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-17",
        "last_updated": "2011-11-21",
        "status": "A",
        "authorized_official_last_name": "MAYNARD",
        "authorized_official_first_name": "DALE",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "405-601-0700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "OK",
            "license": "3752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mel Vision LLC
• Leslie Melton
• Jeffrey P Meyer, MD
• Clay C Michels, DDS
• Mid Star Lab Inc
• Mid-del Dental Solutions, P.C.
• Mid-del Physical Therapy Clinic Inc.
• Mid-del Vision Source PLLC
• Mid-del Youth & Family Center, Inc.
• Midwest Pain Consultants P C

• Chiropractor in Del City, OK
• Providers in Del City, OK by specialty
• Chiropractor in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2011; 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.