NPIMap

Organization Active NPI

Derstine Chiropractic Clinic

  • Chiropractor
  • Sapulpa, OK
National Provider Identifier
1740483841
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1691 Issued in OK
Legal business name
DERSTINE CHIROPRACTIC CLINIC
Practice address
20 S Water St
Sapulpa, OK 74066-4232
Phone
(918) 224-6050
Fax
(918) 224-6029
NPI assigned
Jun 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Thomas A Derstine, D.C.NPI 1477665941
Title
Owner
Phone
(918) 224-6050

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 1691 OK Primary

Addresses

Primary practice location

20 S Water St
Sapulpa, OK 74066-4232

Mailing address

20 S Water St
Sapulpa, OK 74066-4232
Phone (918) 224-6050

National Provider Directory

National Provider Directory

Locations

20 S Water St
Sapulpa, OK 74066
Phone (918) 224-6050

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1181088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1740483841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 S WATER ST",
            "city": "SAPULPA",
            "state": "OK",
            "postal_code": "740664232",
            "telephone_number": "918-224-6050",
            "fax_number": "918-224-6029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 S WATER ST",
            "city": "SAPULPA",
            "state": "OK",
            "postal_code": "740664232",
            "telephone_number": "918-224-6050",
            "fax_number": "918-224-6029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERSTINE CHIROPRACTIC CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DERSTINE",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "918-224-6050",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "OK",
            "license": "1691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sapulpa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.