Samuel Diskerud

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

4565 Issued in OK

Practice address

900 W Kenosha St
Broken Arrow, OK 74012-8917

Phone

(918) 251-8889

NPI assigned

Aug 30, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Chiropractic

Education

Logan College of Chiropractic, 2023

Medicare assignment

May accept Medicare assignment

Group practices

Dr. John K. Whitham, PCGroup PAC ID 9931241254, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Dr. John K. Whitham, PC

  • Clinic/Center
  • Broken Arrow, OK
  • NPI 1568693919
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1693353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771804800000",
    "number": "1689459208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 W KENOSHA ST",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740128917",
            "telephone_number": "918-251-8889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 W KENOSHA ST",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740128917",
            "telephone_number": "918-251-8889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DISKERUD",
        "first_name": "SAMUEL",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-30",
        "last_updated": "2026-02-23",
        "certification_date": "2026-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OK",
            "license": "4565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Ann Devilliers, OTR
• Ascension Diaz
• Linzy Jordon Dill
• Katharine Ann Dillsaver, OTRL
• Jeromy Dionne
• Allen Eugene Dixon Jr.
• Ashley Michelle Dixon, APRN
• Holli T Dixon, DPH
• Quang DO
• Stephen Lam DO, PHARMD

• Chiropractor in Broken Arrow, OK
• Providers in Broken Arrow, OK by specialty
• Chiropractor in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.