Active NPI
Eugene E Bledsoe, D.C.
- Chiropractor
- Bristow, OK
National Provider Identifier
1710056403
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 3360
- Practice address
- 116 W 8TH Ave
Bristow, OK 74010-2412 - Phone
- (918) 367-9600
- Fax
- (918) 367-9699
- NPI assigned
- Nov 7, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- Cleveland Chiropractic College - Kansas City, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
509 N Main St
Bristow, OK 74010-2016
Phone (918) 367-9600
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OK
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080509000258 | OK | Practitioner - Chiropractic | 8022197458 | Practice locations: Bristow, OK |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3360 | OK | MD | Internal Medicine Physician |
Specialties & licenses 1
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 3360 | OK | Primary |
Addresses
NPPES NPI RegistryPrimary practice location
116 W 8TH Ave
Bristow, OK 74010-2412
Mailing address
116 W 8TH Ave
Bristow, OK 74010-2412
Phone (918) 367-9600
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 8, 2007.
{
"created_epoch": "1162857600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1710056403",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "116 W 8TH AVE",
"city": "BRISTOW",
"state": "OK",
"postal_code": "740102412",
"telephone_number": "918-367-9600",
"fax_number": "918-367-9699"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "116 W 8TH AVE",
"city": "BRISTOW",
"state": "OK",
"postal_code": "740102412",
"telephone_number": "918-367-9600",
"fax_number": "918-367-9699"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLEDSOE",
"first_name": "EUGENE",
"middle_name": "E",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-07",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "OK",
"license": "3360",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bristow, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.