Individual provider Active NPI

Justin Gregg Snyder, D.C.

  • Chiropractor
  • Tulsa, OK
National Provider Identifier
1730398785
Registry record updated Dec 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3838 Issued in OK
Practice address
4146 S Harvard Ave Ste F-5
Tulsa, OK 74135-2610
Phone
(918) 749-7772
NPI assigned
May 22, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 18, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3838 OK Primary

Addresses

Primary practice location

4146 S Harvard Ave Ste F-5
Tulsa, OK 74135-2610

Mailing address

2418 S Louisville Ave
Tulsa, OK 74114-3424
Phone (918) 749-7772

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090925000087 OK Practitioner - Chiropractic 3678629185 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Cleveland Chiropractic College - Kansas City, 2007
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4146 S Harvard Ave
Suite F5
Tulsa, OK 74135-2610
Phone (918) 749-7772

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Snyder Chiropractic P.L.L.C. Chiropractor CurrentSince Jul 6, 2009 Accepting new patients

Locations

4146 S Harvard Ave
Ste F5
Tulsa, OK 74135
Phone (918) 749-7772

Organizations & group practices 1

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": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261094400000",
    "number": "1730398785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2418 S LOUISVILLE AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741143424",
            "telephone_number": "918-749-7772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4146 S HARVARD AVE STE F-5",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741352610",
            "telephone_number": "918-749-7772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SNYDER",
        "first_name": "JUSTIN",
        "middle_name": "GREGG",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-22",
        "last_updated": "2009-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OK",
            "license": "3838",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2009; 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.