Active NPI
Charles M Popa III, D.C.
- Chiropractor
- Fairfield Township, OH
National Provider Identifier
1063473940
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 2006
- Practice address
- 3328 Princeton Road
Fairfield Township, OH 45011-5390 - Phone
- (513) 887-9400
- Fax
- (513) 887-7512
- NPI assigned
- Mar 30, 2006
- Last updated
- Apr 16, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 2006 | OH | Primary |
| Chiropractor | 111N00000X | 08002022A | IN |
Addresses
Primary practice location
3328 Princeton Road
Fairfield Township, OH 45011-5390
Mailing address
3328 Princeton Road
Fairfield Township, OH 45011-5390
Phone (513) 887-9400
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0966656 | Medicaid | OH | |
| 200847630 | Medicaid | IN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 08002022A | IN | MD | Chiropractor |
| 2006 | OH | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Principled Physicians & Rehabilitation Center of Cincinnati | Chiropractor | Past | Accepting new patients |
| Principled Physicians and Rehabilitation Center of Lawrenceburg | Chiropractor | Past | Accepting new patients |
| Physicians Wellness Center, LLC | Past | Accepting new patients |
Organizations & group practices 5
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- General Practice Physician
- Hamilton, OH
- NPI 1609154152
-
- Chiropractor
- Cincinnati, OH
- NPI 1396783577
-
- Chiropractor
- Hamilton, OH
- NPI 1558315978
-
- Specialist
- Clearwater Beach, FL
- NPI 1760928063
-
- Chiropractor
- Lawrenceburg, IN
- NPI 1467499194
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143676800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1334534400000",
"number": "1063473940",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3328 PRINCETON ROAD",
"city": "FAIRFIELD TOWNSHIP",
"state": "OH",
"postal_code": "450115390",
"telephone_number": "513-887-9400",
"fax_number": "513-887-7512"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3328 PRINCETON ROAD",
"city": "FAIRFIELD TOWNSHIP",
"state": "OH",
"postal_code": "450115390",
"telephone_number": "513-887-9400",
"fax_number": "513-887-7512"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POPA",
"first_name": "CHARLES",
"middle_name": "M",
"name_suffix": "III",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-30",
"last_updated": "2012-04-16",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "OH",
"license": "2006",
"primary": true
},
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "IN",
"license": "08002022A",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0966656",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200847630",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Fairfield Township, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.