Independent US Healthcare Provider Directory & Public Medical Database
Deactivated NPI 1518955947 Deactivated / Inactive NPI Male Practitioner

Dr. Russell Jeriah Prentice , DC

Chiropractor • Jenks, OK

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Russell Prentice has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date October 10, 2005
NPI Deactivation Date December 29, 2006
Total Practice Duration ~1 Years of Practice (2005 – 2006)

Professional Overview & Biography Verified Profile Summary

Dr. Russell Prentice, DC was a registered Chiropractor practicing in Jenks, OK. Throughout an active medical career spanning 1 years, Dr. Prentice provided care at the practice location at 9428 S ELWOOD AVE until profile deactivation on 2006-12-29.

Practice Location & Contact Primary Location

Practice Address

9428 S Elwood Ave
Suite 102

Jenks, OK 740372317

Telephone 9182960525
Fax 9182960526
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Chiropractor in Jenks, OK

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 26.5 Yrs
State Avg: 22.8 Yrs
Regional Practice Density
12 Specialists

Practicing in Jenks, OK (1065 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Chiropractor Primary Specialty

NUCC Taxonomy Code: 111N00000X

State License OK 3725

A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.

Additional State Medicaid & Healthcare Payer Identifiers

Commercial Insurance / Payer ID Group Npi Prentice Family
1104991280

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners
NPI 1134101322

Doctor of Chiropractic

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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Updated Practice Location July 08, 2007

Registered at 9428 S ELWOOD AVE, SUITE 102, JENKS, OK 740372317 (Tel: 9182960525)

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Updated Business Mailing Address July 08, 2007

Registered at 9428 S ELWOOD AVE, SUITE 102, JENKS, OK 740372317 (Tel: 9182960525)

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Provider Name / Credentials Updated July 08, 2007

Recorded as RUSSELL PRENTICE, DC

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Chiropractor (License #3725 in OK)

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NPI Profile Reactivated January 04, 2007

Record officially reactivated for active practice on January 04, 2007

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NPI Profile Deactivated December 29, 2006

Record deactivated on December 29, 2006

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Initial NPI Registration & Enumeration October 10, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1518955947
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 10, 2005
Last Update: July 08, 2007
Deactivation Date: December 29, 2006
Sole Proprietor: No

Mailing Address

9428 S Elwood Ave, Suite 102

Jenks, OK 740372317

Phone: 9182960525

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.