Tyler Ray Bodin, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

3813 Issued in OK

Practice address

1021 SW. 19TH St.
Moore, OK 73160-2806

Phone

(405) 703-2694

Fax

(405) 703-2848

NPI assigned

Jul 19, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Enrollment records 1

Specialty

Chiropractic

Education

Cleveland Chiropractic College - Kansas City, 2005

Medicare assignment

May accept Medicare assignment

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Bodin Chiropractic PLLC

  • Chiropractor
  • Moore, OK
  • NPI 1538299946
  Medicare reassignment NPD Authorized official
• Summit Medical Center

  • General Acute Care Hospital
  • Edmond, OK
  • NPI 1356574560
  NPD (past)

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1730108697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12445 ALAMEDA TRACE CIR",
            "address_2": "#312",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787276390",
            "telephone_number": "512-297-2231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1021 SW. 19TH ST.",
            "city": "MOORE",
            "state": "OK",
            "postal_code": "731602806",
            "telephone_number": "405-703-2694",
            "fax_number": "405-703-2848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODIN",
        "first_name": "TYLER",
        "middle_name": "RAY",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OK",
            "license": "3813",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abbie Blalock
• Michael Wayne Blomstrom, PTA
• Bluebirdmassageandwellness, PLLC
• Randi Bock
• Bodin Chiropractic PLLC
• Tanner Lee Boles, M.A.
• Kaitlyn Abigail Bonner
• Jessica Lynne Borelli
• Kamyshia Elizabeth Bostick, LMSW
• Rebecca Cortez Boston

• Chiropractor in Moore, OK
• Providers in Moore, OK by specialty
• Chiropractor in Oklahoma

• 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.

Verify at the official NPI Registry.