Individual provider Active NPI

Tanner Samuel Oxford, DC

  • Chiropractor
  • Altus, OK
National Provider Identifier
1821733916
Registry record updated Jul 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4414 Issued in OK
Practice address
901 Falcon Rd
Altus, OK 73521-2833
Phone
(580) 335-1977
NPI assigned
May 3, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 4414 OK Primary

Addresses

Primary practice location

901 Falcon Rd
Altus, OK 73521-2833

Mailing address

901 Falcon Rd
Altus, OK 73521-2833
Phone (580) 335-1977

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230501000463 OK Practitioner - Chiropractic 8123483997 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

901 Falcon Rd
Altus, OK 73521-2833
Phone (580) 301-6692

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4414OKMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Jackson County Memorial Hospital Authority Single Specialty Past Accepting new patients
Elledge Chiropractic Clinic PLLC Chiropractor PastSince Dec 1, 2022 Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1651536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721433600000",
    "number": "1821733916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 FALCON RD",
            "city": "ALTUS",
            "state": "OK",
            "postal_code": "735212833",
            "telephone_number": "580-335-1977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 FALCON RD",
            "city": "ALTUS",
            "state": "OK",
            "postal_code": "735212833",
            "telephone_number": "580-335-1977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OXFORD",
        "first_name": "TANNER",
        "middle_name": "SAMUEL",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-05-03",
        "last_updated": "2024-07-20",
        "certification_date": "2024-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "OK",
            "license": "4414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Altus, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.