Fairview Family & Sports Chiropractic, P.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2433 Issued in OK

Legal business name

FAIRVIEW FAMILY & SPORTS CHIROPRACTIC, P.C.

Practice address

301 W Elm St
Fairview, OK 73737-1618

Phone

(580) 227-3515

Fax

(580) 227-3667

NPI assigned

Apr 17, 2011

Last updated

Apr 17, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Justin Mark Keen, D.C.NPI 1447343702

Title

President

Phone

(580) 227-3515

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.

• Justin Mark Keen, D.C.

  • Sports Physician Chiropractor
  • Fairview, OK
  • NPI 1447343702
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1302998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302998400000",
    "number": "1962792507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 W ELM ST",
            "city": "FAIRVIEW",
            "state": "OK",
            "postal_code": "737371618",
            "telephone_number": "580-227-3515",
            "fax_number": "580-227-3667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 W ELM ST",
            "city": "FAIRVIEW",
            "state": "OK",
            "postal_code": "737371618",
            "telephone_number": "580-227-3515",
            "fax_number": "580-227-3667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRVIEW FAMILY & SPORTS CHIROPRACTIC, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-17",
        "last_updated": "2011-04-17",
        "status": "A",
        "authorized_official_last_name": "KEEN",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_middle_name": "MARK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "580-227-3515",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OK",
            "license": "2433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Raegan Dewilde
• Kaci Ranae Edwards
• Larry Shane Elliott
• Entrust DPC PLLC
• Megan Leigh Ewing, APRN-CNP
• Fairview Fellowship Home for Senior Citizens, Inc.
• Fairview Regional Medical Center
• Fairview Regional Medical Center Authority (Fairview Regional Medical Center)
• Fairview Regional Medical Center Authority
• Fairview Regional Medical Center Authority (Fairview Family Clinic)

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2011; 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.