Dylan Robert Black, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

DC05327 Issued in OH

Practice address

3060 Dayton Xenia Rd Ste C
Beavercreek, OH 45434-6393

Phone

(937) 427-2225

Fax

(937) 405-1078

NPI assigned

Dec 28, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Specialty

Chiropractic

Education

Logan College of Chiropractic, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Advanced Medical and Wellness Center, Inc.Group PAC ID 0547536187, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Advanced Medical & Wellness Center, Inc.

  • General Practice Physician
  • Beavercreek, OH
  • NPI 1598281057

  Single Specialty

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1703721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703808000000",
    "number": "1053180240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3060 DAYTON XENIA RD STE C",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454346393",
            "telephone_number": "937-427-2225",
            "fax_number": "937-405-1078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3060 DAYTON XENIA RD STE C",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454346393",
            "telephone_number": "937-427-2225",
            "fax_number": "937-405-1078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "DYLAN",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-12-28",
        "last_updated": "2023-12-29",
        "certification_date": "2023-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "DC05327",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephen Binder, MD
• Caitlyn M Bird
• Kara M Birkemeier
• Caleb Gerald Black, MD
• Derek Robert Black, D.C.
• Marcia Black, PT
• Allyson Michelle Blakemore, APRN AG-ACNP
• Jessica L Blank
• Jessica Renee Bledsoe
• Blissful Body Massage, LLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.