Individual provider Active NPI

Wade E. Bair, D.C.

  • Chiropractor
  • Stillwater, OK
National Provider Identifier
1710136312
Registry record updated Oct 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3896 Issued in OK
Practice address
1405 W. 12TH Ave.
Stillwater, OK 74074
Phone
(405) 533-1511
Fax
(405) 533-1161
NPI assigned
Sep 18, 2008
Last updated
Oct 24, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 24, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3896 OK Primary

Addresses

Primary practice location

1405 W. 12TH Ave.
Stillwater, OK 74074

Mailing address

1405 W. 12TH Ave.
Stillwater, OK 74074
Phone (405) 533-1511

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090421000685 OK Practitioner - Chiropractic 6901953322

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1405 W 12TH Ave
Stillwater, OK 74074-5425

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Chiropractic & Wellness, PLLC Chiropractor CurrentSince Jul 1, 2014 Accepting new patients

Locations

1405 W 12th Ave
Stillwater, OK 74074
Phone (405) 533-1511

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, 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": "1221696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319414400000",
    "number": "1710136312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1405 W. 12TH AVE.",
            "city": "STILLWATER",
            "state": "OK",
            "postal_code": "74074",
            "telephone_number": "405-533-1511",
            "fax_number": "405-533-1161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 W. 12TH AVE.",
            "city": "STILLWATER",
            "state": "OK",
            "postal_code": "74074",
            "telephone_number": "405-533-1511",
            "fax_number": "405-533-1161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAIR",
        "first_name": "WADE",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-09-18",
        "last_updated": "2011-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OK",
            "license": "3896",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stillwater, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2011; 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.