Organization Active NPI

Coweta Family Chiropractic Clinic PLLC

  • Preferred Provider Organization
  • Coweta, OK
National Provider Identifier
1770709248
Registry record updated Aug 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Preferred Provider OrganizationTaxonomy code 305R00000X
Legal business name
COWETA FAMILY CHIROPRACTIC CLINIC PLLC
Practice address
13783 S St Hwy 51
Coweta, OK 74429-0333
Phone
(918) 279-1310
Fax
(918) 279-8160
NPI assigned
Apr 17, 2007
Last updated
Aug 17, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2007

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

Authorized official

Name
Dr. Robert J McKinney, D.C.NPI 1376550574
Title
Owner
Phone
(918) 279-1310

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
Preferred Provider Organization 305R00000X Primary

Addresses

Primary practice location

13783 S St Hwy 51
Coweta, OK 74429-0333

Mailing address

PO Box 333
Coweta, OK 74429-0333
Phone (918) 279-1310

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070809000329 OK Part B Supplier - Clinic/Group Practice 7012008774 Receives reassigned benefits from 1 practitioner
Practice locations: Coweta, OK

National Provider Directory

National Provider Directory

Locations

13783 S State Highway 51
Coweta, OK 74429
Phone (918) 279-1310

13831 S State Highway 51
Coweta, OK 74429
Phone (918) 279-1310

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187308800000",
    "number": "1770709248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 333",
            "city": "COWETA",
            "state": "OK",
            "postal_code": "744290333",
            "telephone_number": "918-279-1310",
            "fax_number": "918-279-8160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13783 S ST HWY 51",
            "city": "COWETA",
            "state": "OK",
            "postal_code": "744290333",
            "telephone_number": "918-279-1310",
            "fax_number": "918-279-8160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COWETA FAMILY CHIROPRACTIC CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-17",
        "last_updated": "2007-08-17",
        "status": "A",
        "authorized_official_last_name": "MCKINNEY",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "918-279-1310",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coweta, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.