South Tulsa Chiropractic PC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

3607 Issued in OK

Legal business name

SOUTH TULSA CHIROPRACTIC PC

Practice address

930 West Main Street
Jenks, OK 74037

Phone

(918) 299-5559

Fax

(844) 313-8408

NPI assigned

Apr 17, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Timothy Shane Harris, DC

Title

Owner

Phone

(918) 299-5559

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Locations

Practitioners 1

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.

• Tim S Harris, DC

  • Chiropractor
  • Jenks, OK
  • NPI 1407941024
  Medicare reassignment NPD

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1544140800000",
    "number": "1780800276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "930 WEST MAIN STREET",
            "city": "JENKS",
            "state": "OK",
            "postal_code": "74037",
            "telephone_number": "918-299-5559",
            "fax_number": "844-313-8408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 WEST MAIN STREET",
            "city": "JENKS",
            "state": "OK",
            "postal_code": "74037",
            "telephone_number": "918-299-5559",
            "fax_number": "844-313-8408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH TULSA CHIROPRACTIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-17",
        "last_updated": "2018-12-07",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "SHANE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "918-299-5559",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "OK",
            "license": "3607",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dustin W. Smith, D.O.
• Kaitlyn Cheyenne Smith
• Tyler Smith, NP
• Jaina Soodsma
• Trina Souders, SLP
• South Tulsa Physical Therapy Limited Partnership (Physical Therapy of Jenks)
• South Tulsa Plastic Surgery Center
• Southside Behavioral Health LLC
• Lana Spandley, PHARMD
• Speech and Beyond MH

• Chiropractor in Jenks, OK
• Providers in Jenks, OK by specialty
• Chiropractor in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2018; 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.