Individual provider Active NPI

Charles M Popa III, D.C.

  • Chiropractor
  • Fairfield Township, OH
National Provider Identifier
1063473940
Registry record updated Apr 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2006 Issued in OH
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, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
0966656MedicaidOH
200847630MedicaidIN

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. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
08002022AINMDChiropractor
2006OHMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Principled Physicians & Rehabilitation Center of Cincinnati Chiropractor PastSince Feb 1, 2006 Accepting new patients
Principled Physicians and Rehabilitation Center of Lawrenceburg Chiropractor PastSince Oct 1, 2006 Accepting new patients
Physicians Wellness Center, LLC PastSince Apr 1, 2017 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.

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.

Verify at the official NPI Registry.