Mikayla Storm Eldridge, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

4427 Issued in OK

Practice address

117 N Garfield Ave
Sand Springs, OK 74063-7214

Phone

(918) 802-2066

NPI assigned

Aug 27, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Mikayla Storm Jones Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Genesis Family Chiropractic, LLC

  • Chiropractor
  • Sand Springs, OK
  • NPI 1912751967
  NPD

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

{
    "created_epoch": "1566864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693872000000",
    "number": "1881242683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5209 SKYLANE DR",
            "city": "SAND SPRINGS",
            "state": "OK",
            "postal_code": "740633258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 N GARFIELD AVE",
            "city": "SAND SPRINGS",
            "state": "OK",
            "postal_code": "740637214",
            "telephone_number": "918-802-2066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELDRIDGE",
        "first_name": "MIKAYLA",
        "middle_name": "STORM",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-27",
        "last_updated": "2023-09-05",
        "certification_date": "2023-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OK",
            "license": "4427",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NH",
            "license": "1044",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NH",
            "license": "1059",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MIKAYLA",
            "last_name": "JONES",
            "middle_name": "STORM",
            "credential": "DC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Chiropractor in Sand Springs, OK
• Providers in Sand Springs, OK by specialty
• Chiropractor in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.