Organization Active NPI

Cody Elledge D.C. PLLC

  • Chiropractor
  • Oklahoma City, OK
National Provider Identifier
1821438854
Registry record updated Jul 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3835 Issued in OK
Legal business name
CODY ELLEDGE D.C. PLLC
Practice address
5715 N Western Ave Ste B
Oklahoma City, OK 73118-1239
Phone
(405) 703-3033
NPI assigned
Jul 5, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2013

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

Authorized official

Name
Dr. Cody Elledge, D.C.NPI 1639372956
Title
Sole Member
Phone
(405) 703-3033

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X 3835 OK Primary
AcupuncturistGroup: 193200000X MULTI-SPECIALTY GROUP 171100000X

Addresses

Primary practice location

5715 N Western Ave Ste B
Oklahoma City, OK 73118-1239

Mailing address

5715 N Western Ave Ste B
Oklahoma City, OK 73118-1239
Phone (405) 703-3033

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140514001721 OK Part B Supplier - Clinic/Group Practice 7618190976 Receives reassigned benefits from 2 practitioners
Practice locations: Oklahoma City, OK

National Provider Directory

National Provider Directory

Locations

5715 N Western Ave
Ste B
Oklahoma City, OK 73118
Phone (405) 858-2225

5715 N Western Ave
Oklahoma City, OK 73118

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1372982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372982400000",
    "number": "1821438854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5715 N WESTERN AVE STE B",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731181239",
            "telephone_number": "405-703-3033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5715 N WESTERN AVE STE B",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731181239",
            "telephone_number": "405-703-3033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CODY ELLEDGE D.C. PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-05",
        "last_updated": "2013-07-05",
        "status": "A",
        "authorized_official_last_name": "ELLEDGE",
        "authorized_official_first_name": "CODY",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "405-703-3033",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "OK",
            "license": "3835",
            "primary": true
        },
        {
            "code": "171100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2013; 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.