1790906030 NPI number — CHIROPRACTICARE, INC.

Table of content: (NPI 1790906030)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1790906030 NPI number — CHIROPRACTICARE, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CHIROPRACTICARE, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1790906030
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/02/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
100 HIGHVIEW BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
COLUMBUS
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43207-6023
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
614-492-0414
Provider Business Mailing Address Fax Number:
614-492-9440

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2879 E DUBLIN GRANVILLE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COLUMBUS
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43231-4063
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
614-898-0787
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/02/2007

Additional Information

Authorized Official

Authorized Official Last Name:
APPELL
Authorized Official First Name:
JAMES
Authorized Official Middle Name:
JOSEPH
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
614-492-0414

Provider Taxonomy Codes

  • Taxonomy code: 111NR0400X , with the licence number:  2428 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363A00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 44-02623 . This is a "UHC" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 4509819 . This is a "AETNA" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 350046273 . This is a "RAIL RD. MEDICARE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 122593 . This is a "ANTHEM BC BS" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 315150781 . This is a "MEDICAL MUTUAL" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".




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