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PROACTIVE SPORT AND SPINE PLC
NPI 1114260593
Chiropractor in Broken Arrow, OK

Active since April 03, 2013
4412 W HOUSTON ST, BROKEN ARROW, OK 74012(918) 254-8700(918) 254-8711 Get Directions Write a Review

NPPES record last updated: April 3, 2013. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Proactive Sport And Spine Plc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PROACTIVE SPORT AND SPINE PLC (NPI 1114260593) is a healthcare organization registered as a chiropractor in Broken Arrow, Oklahoma and active in the NPI registry since April 2013. The organization lists Travis J Dearmon, Chiropractor, as its authorized official.

NPPES Registry Identity

NPI1114260593
Entity TypeOrganization
Primary Taxonomy111N00000X
Legal Business NamePROACTIVE SPORT AND SPINE PLC
Location Address4412 W HOUSTON STBroken Arrow, OK 74012-4645
Mailing Address4412 W HoustonBroken Arrow, OK 74012 · (918) 254-8700 · Fax (918) 254-8711
Phone(918) 254-8700
Fax(918) 254-8711
Organization SubpartNo
Authorized OfficialTravis J DearmonChiropractor · (918) 254-8700
Enumeration DateApril 3, 2013
✔ NPI 1114260593 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyChiropractorChiropractic Providers
Taxonomy Code111N00000X
License✔ Licensed in OK · 3846
Definition
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.
4412 W HOUSTON ST, Broken Arrow, OK 74012
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Other Identifiers 1

Medicare PIN239725001OK

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Proactive Sport And Spine Plc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Proactive Sport And Spine Plc, which bills Medicare for the services this clinician delivers.

Clinician (1)

Travis Dearmon, D.C.
Chiropractic
NPI 1063603603
4412 W. HOUSTON
Broken Arrow, OK 74012
(918) 254-8700
Same address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Proactive Sport And Spine Plc's NPI number?

The NPI number for Proactive Sport And Spine Plc is 1114260593. It was assigned to this organization in the NPPES registry on April 3, 2013.

Where is Proactive Sport And Spine Plc located?

Proactive Sport And Spine Plc is located at 4412 W Houston St, Broken Arrow, OK 74012. The listed phone number is (918) 254-8700.

What is Proactive Sport And Spine Plc's specialty?

The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.

Is Proactive Sport And Spine Plc enrolled in Medicare?

Yes. Proactive Sport And Spine Plc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Proactive Sport And Spine Plc?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Chiropractic) reassigns their Medicare billing to Proactive Sport And Spine Plc. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Proactive Sport And Spine Plc was last updated on April 3, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.