Unknown Individual – Chiropractor, NPI 1174543383

Unknown Individual is a healthcare provider. based in Oklahoma city, Oklahoma. specializing in Chiropractor. They hold a License No. 3758 (OK). The NPI Number for Unknown Individual is 1174543383

Main info

Organization
Inactive
21 Years Of Experience
Name
Unknown Individual
NPI
1174543383
Phone
(405) 604-5295
Address
8013 S WESTERN AVE
Deactivation Date
1 December 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4056045295
Graduation Year
2005 (21 years ago)
PAC ID
5890710032
Group Practice PAC ID
4082610068
Professional Enrollment ID
I20051202000404
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 8013, South Western Avenue, Oklahoma City, Oklahoma County, Oklahoma, 73139, United States

    SUITE A

    OKLAHOMA CITY, OK 731392537

    Phone: (405) 604-5295

    Fax: (405) 604-5297

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 73139)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4082610068View full group profile
NameSpecialtyState
C H I R O P R A C T I CTN
C H I R O P R A C T I COK

Reviews

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Frequently asked questions

How do payers reference Unknown Individual?
For Unknown Individual, use NPI 1174543383 as the unique 10-digit identifier.
Is inactive the same as retired for Unknown Individual?
Inactive registry status can reflect deactivation, consolidation, or data lag.
What area of care is associated with Unknown Individual?
Unknown Individual's record emphasizes Chiropractor. Clinical services aligned with this taxonomy classification.
What practice footprint exists for Unknown Individual?
Travel planning: use Oklahoma City, Oklahoma as the reference point for Unknown Individual, then confirm.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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