Individual provider Active NPI

Colton Mark Shearwood, D.C.

  • Chiropractor
  • Stigler, OK
National Provider Identifier
1780460543
Registry record updated Sep 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4518 Issued in OK
Practice address
909 W Main St
Stigler, OK 74462-2341
Phone
(918) 967-3900
Fax
(918) 967-3908
NPI assigned
Sep 6, 2023
Last updated
Sep 6, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4518 OK Primary

Addresses

Primary practice location

909 W Main St
Stigler, OK 74462-2341

Mailing address

909 W Main St
Stigler, OK 74462-2341
Phone (918) 967-3900

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240311001043 OK Practitioner - Chiropractic 1759727936 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Shearwood Chiropractic Clinic Inc Chiropractor CurrentSince Jan 2, 2024 Accepting new patients

Locations

909 W Main St
Stigler, OK 74462
Phone (918) 894-2326

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": "1693958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693958400000",
    "number": "1780460543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 W MAIN ST",
            "city": "STIGLER",
            "state": "OK",
            "postal_code": "744622341",
            "telephone_number": "918-967-3900",
            "fax_number": "918-967-3908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 W MAIN ST",
            "city": "STIGLER",
            "state": "OK",
            "postal_code": "744622341",
            "telephone_number": "918-967-3900",
            "fax_number": "918-967-3908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEARWOOD",
        "first_name": "COLTON",
        "middle_name": "MARK",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-09-06",
        "last_updated": "2023-09-06",
        "certification_date": "2023-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OK",
            "license": "4518",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stigler, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2023; 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.