Organization Active NPI

Lewis Family Chiropractic, Inc.

  • Chiropractor
  • Streetsboro, OH
National Provider Identifier
1003091034
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2648 Issued in OH
Legal business name
LEWIS FAMILY CHIROPRACTIC, INC.
Practice address
9304 State Route 43
Streetsboro, OH 44241-5326
Phone
(330) 422-1551
NPI assigned
Jan 9, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Sam R Lewis, DCNPI 1871676650
Title
Owner
Phone
(330) 422-1551

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 2648 OH Primary

Addresses

Primary practice location

9304 State Route 43
Streetsboro, OH 44241-5326

Mailing address

9304 State Route 43
Streetsboro, OH 44241-5326
Phone (330) 422-1551

Other identifiers 2

IdentifierTypeStateIssuer
000000213133OtherOHANTHEM BLUE CROSS BLUE SH
P00093170OtherOHMEDICARE RAILROAD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040614001043 OH Part B Supplier - Clinic/Group Practice 1557345055 Receives reassigned benefits from 1 practitioner
Practice locations: Streetsboro, OH

National Provider Directory

National Provider Directory

Locations

9304 State Route 43
Streetsboro, OH 44241
Phone (330) 422-1551

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1199836800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1003091034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9304 STATE ROUTE 43",
            "city": "STREETSBORO",
            "state": "OH",
            "postal_code": "442415326",
            "telephone_number": "330-422-1551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9304 STATE ROUTE 43",
            "city": "STREETSBORO",
            "state": "OH",
            "postal_code": "442415326",
            "telephone_number": "330-422-1551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEWIS FAMILY CHIROPRACTIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-09",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "SAM",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "330-422-1551",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "2648",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS BLUE SH",
            "identifier": "000000213133",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00093170",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Streetsboro, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.