Active NPI
Mahla Mohsenzadeh
- Chiropractor
- Nichols Hills, OK
National Provider Identifier
1760009229
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 4276
- Practice address
- 6442 Avondale Dr
Nichols Hills, OK 73116-6404 - Phone
- (405) 286-1259
- NPI assigned
- Jul 1, 2020
- Last updated
- Jun 30, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 4276 | OK | Primary |
Addresses
Primary practice location
6442 Avondale Dr
Nichols Hills, OK 73116-6404
Mailing address
6708 NW 123Rd St
Oklahoma City, OK 73142-3109
Phone (405) 414-8376
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4276 | OK | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Revive Medical LLC | Past | Accepting new patients | |
| Revive Health of Oklahoma LLC | Past | Accepting new patients |
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.
-
dba Revive Health Of Oklahoma
- General Practice Physician
- Oklahoma City, OK
- NPI 1740842327
-
- General Practice Physician
- Oklahoma City, OK
- NPI 1528578499
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1593561600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1625011200000",
"number": "1760009229",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6708 NW 123RD ST",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731423109",
"telephone_number": "405-414-8376"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6442 AVONDALE DR",
"city": "NICHOLS HILLS",
"state": "OK",
"postal_code": "731166404",
"telephone_number": "405-286-1259"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOHSENZADEH",
"first_name": "MAHLA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-07-01",
"last_updated": "2021-06-30",
"certification_date": "2021-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "OK",
"license": "4276",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Nichols Hills, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.