Active NPI
Cord Tanner Landrum, D.C., PA-C
- Physician Assistant
- Ada, OK
National Provider Identifier
1801986740
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 3003
- Practice address
- 905 Colony Dr
Ada, OK 74820-2329 - Phone
- (580) 436-5111
- Fax
- (580) 436-1159
- NPI assigned
- Oct 13, 2006
- Last updated
- Nov 22, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 3003 | OK | Primary |
| Chiropractor | 111N00000X | 3744 | OK |
Addresses
Primary practice location
905 Colony Dr
Ada, OK 74820-2329
Mailing address
527 W 3Rd St
Konawa, OK 74849-1415
Phone (580) 925-3286
Other practice location 1
527 W 3rd St
Konawa, OK 74849-1415
Phone (580) 925-3286
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3003 | Other | OK | OKLAHOMA BOARD OF MEDICAL LICENSURE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OK
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1221 Arlington St
Ada, OK 74820-4067
Phone 5809253286227
304 N Monte Vista St
Ada, OK 74820-7484
Phone (580) 436-5111
527 W 3Rd St
Konawa, OK 74849-1415
Phone 5809253286227
709 Better Now PLZ
Ada, OK 74820-2279
Phone (580) 310-9899
905 Colony Dr
Ada, OK 74820-2329
Phone (580) 436-5111
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3744 | OK | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Central Oklahoma Family Medical Center, Inc | Current | Accepting new patients | |
| Jackson County Memorial Hospital Authority | Past | Accepting new patients | |
| Cord T Landrum DCPC | Chiropractor | Past | Accepting new patients |
| Summit Medical Center | Past | Accepting new patients | |
| Central Oklahoma Family Medical Center, Inc. | Past | Accepting new patients |
Locations
905 Colony Dr
Ada, OK 74820
Phone (580) 434-5111
527 W 3rd St
Konawa, OK 74849
Phone (580) 925-3286
Interoperability endpoints
- cord.landrum@cof.eclinicaldirectplus.com
Organizations & group practices 6
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.
-
- Federally Qualified Health Center (FQHC)
- Konawa, OK
- NPI 1831291293
-
- Family Nurse Practitioner
- Ada, OK
- NPI 1891222030
-
- Federally Qualified Health Center (FQHC)
- Ada, OK
- NPI 1144997693
-
- General Acute Care Hospital
- Altus, OK
- NPI 1093763781
-
- General Acute Care Hospital
- Edmond, OK
- NPI 1356574560
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Sulphur, OK
- NPI 1861736969
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160697600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1637539200000",
"number": "1801986740",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "527 W 3RD ST",
"city": "KONAWA",
"state": "OK",
"postal_code": "748491415",
"telephone_number": "580-925-3286",
"fax_number": "580-925-9149"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "905 COLONY DR",
"city": "ADA",
"state": "OK",
"postal_code": "748202329",
"telephone_number": "580-436-5111",
"fax_number": "580-436-1159"
}
],
"practiceLocations": [
{
"address_1": "527 W 3rd St",
"address_purpose": "LOCATION",
"city": "Konawa",
"state": "OK",
"postal_code": "748491415",
"country_code": "US",
"telephone_number": "580-925-3286",
"fax_number": "580-925-9149",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LANDRUM",
"first_name": "CORD",
"middle_name": "TANNER",
"name_prefix": "Dr.",
"credential": "D.C., PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-13",
"last_updated": "2021-11-22",
"certification_date": "2021-11-22",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "OK",
"license": "3003",
"primary": true
},
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "OK",
"license": "3744",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OKLAHOMA BOARD OF MEDICAL LICENSURE",
"identifier": "3003",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ada, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.