Individual provider Active NPI

Chesterfield D Featherston IV, DC

  • Chiropractor
  • Broken Arrow, OK
National Provider Identifier
1962809384
Registry record updated Jun 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4175 Issued in OK
Practice address
1107 N Kalanchoe Ave
Broken Arrow, OK 74012-2378
Phone
(918) 543-3020
Fax
(918) 543-2149
NPI assigned
Dec 1, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4175 OK Primary

Addresses

Primary practice location

1107 N Kalanchoe Ave
Broken Arrow, OK 74012-2378

Mailing address

1107 N Kalanchoe Ave
Broken Arrow, OK 74012
Phone (918) 543-3020

Other identifiers 1

IdentifierTypeStateIssuer
519447ZPZPOtherINDIVIDUAL PTAN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160811002587 OK Practitioner - Chiropractic 6305130469 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Brian S. Hicks D.C. Inc PC 2 clinicians

Practice addresses (Care Compare)

7100 E 151St St S
Bixby, OK 74008-4137
Phone (918) 366-4461

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4175OKMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Brian S. Hicks D.C. Inc PC Chiropractor CurrentSince Oct 20, 2017 Accepting new patients
Joint Rehabilitation and Physical Chiropractor CurrentSince Jul 12, 2017 Accepting new patients
Brian S. Hicks D.C. Inc P.C. Chiropractor Past Accepting new patients
Tulsa Family Chiropractic Chiropractor PastSince Oct 20, 2017 Accepting new patients

Locations

7100 E 151st St S
Bixby, OK 74008
Phone (918) 227-2788

1020 E Taft Ave
Sapulpa, OK 74066
Phone (918) 227-2788

Organizations & group practices 4

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": "1417392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1497225600000",
    "number": "1962809384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1107 N KALANCHOE AVE",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "74012",
            "telephone_number": "918-543-3020",
            "fax_number": "918-543-2149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1107 N KALANCHOE AVE",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740122378",
            "telephone_number": "918-543-3020",
            "fax_number": "918-543-2149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEATHERSTON",
        "first_name": "CHESTERFIELD",
        "middle_name": "D",
        "name_suffix": "IV",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-12-01",
        "last_updated": "2017-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OK",
            "license": "4175",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL PTAN",
            "identifier": "519447ZPZP",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Broken Arrow, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2017; 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.