Countryside Wellness LLC
NPI 1205142700ActiveOrganization· Chiropractor· Tahlequah, OK
Chiropractor in Tahlequah, Oklahoma, registered in NPPES in August 2010. The authorized official on file is Kelly J. Callaway, DC, Owner/Chiropractor. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1205142700 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Aug 23, 2010 |
| Last updated in NPPES | Sep 5, 2024 |
| Certified by provider | Sep 5, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Chiropractor Primary | 111N00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (OK) |
|---|
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