Divine Chiropractic and Wellness Center

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

3769 Issued in OH

Legal business name

DIVINE CHIROPRACTIC AND WELLNESS CENTER

Practice address

629 S Ohio Ave
Columbus, OH 43205-2743

Phone

(614) 477-8140

Fax

(614) 258-3811

NPI assigned

Mar 4, 2009

Last updated

Jan 21, 2015By the provider in NPPES

Organization subpart

Yes

Parent organization

DIVINE CHIROPRACTIC AND WELLNESS CENTERAs reported in NPPES

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

Authorized official

Name

Deddeh A. Korvah-Reed, D.CNPI 1376692343

Title

Chiropractor/Owner

Phone

(614) 222-0019

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Part of

Divine Chiropractic and Wellness Center

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Deddeh A. Korvah-Reed, DC

  • Chiropractor
  • Columbus, OH
  • NPI 1376692343
  Medicare reassignment NPD Authorized official
• Kayla Lee, LMT

  • Massage Therapist
  • Columbus, OH
  • NPI 1275309049
  NPD
• Shawndrea Reeves, LMT

  • Massage Therapist
  • Columbus, OH
  • NPI 1972341352
  NPD
• Latia White, LMT

  • Massage Therapist
  • Columbus, OH
  • NPI 1477329241
  NPD

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

{
    "created_epoch": "1236124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421798400000",
    "number": "1033359070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "67 PARSONS AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432153978",
            "telephone_number": "614-222-0019",
            "fax_number": "614-222-0019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "629 S OHIO AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432052743",
            "telephone_number": "614-477-8140",
            "fax_number": "614-258-3811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE CHIROPRACTIC AND WELLNESS CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DIVINE CHIROPRACTIC AND WELLNESS CENTER",
        "enumeration_date": "2009-03-04",
        "last_updated": "2015-01-21",
        "status": "A",
        "authorized_official_last_name": "KORVAH-REED",
        "authorized_official_first_name": "DEDDEH",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "CHIROPRACTOR/OWNER",
        "authorized_official_telephone_number": "614-222-0019",
        "authorized_official_credential": "D.C"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "3769",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2805503",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Diversified Home Medicals, Inc.
• Diversity Home Health Care, Inc.
• Diversity Home Health Services LLC
• Diversity Medical Transportation
• Diversity Medical Transportation, LLC
• Divine Family Eyecare, Inc.
• Divine Hands Home Health Care Inc
• Divine Healthcare Services LLC
• Divine Heart Home Health & Nursing Services
• Divine Home Care Services, LLC

• Chiropractor in Columbus, OH
• Providers in Columbus, OH by specialty
• Chiropractor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2015; 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.