Individual provider Active NPI

Kara Suzanne Davidson, D.C.

  • Chiropractor
  • Waynesfield, OH
National Provider Identifier
1063666519
Registry record updated Aug 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4028 Issued in OH
Practice address
529 N Westminster St
Suite B
Waynesfield, OH 45896-9449
Phone
(419) 568-2225
Fax
(419) 568-2020
NPI assigned
Nov 11, 2008
Last updated
Aug 4, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 4, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038.011139 IL
Chiropractor 111N00000X 4028 OH Primary

Addresses

Primary practice location

529 N Westminster St
Suite B
Waynesfield, OH 45896-9449

Mailing address

529 N Westminster St
Waynesfield, OH 45896-9449
Phone (419) 568-2225

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091217000007 OH Practitioner - Chiropractic 5890858732 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2006
Medicare assignment
May accept Medicare assignment
Group practices
Wilcox Family Chiropractic, LLCGroup PAC ID 3577688837, 2 clinicians

Practice addresses (Care Compare)

1233 W Market St
Lima, OH 45805-2728
Phone (419) 229-2225

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4028OHMDCounseling Psychologist
038.011139ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Wilcox Family Chiropractic, LLC Chiropractor CurrentSince Sep 1, 2010 Accepting new patients
Grundy Family Chiropractic SC Chiropractor PastSince Apr 14, 2024 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

1233 W Market St
Lima, OH 45805
Phone (419) 227-8435

529 N Westminster St
Waynesfield, OH 45896
Phone (419) 227-3978

529 N Westminster St
Ste B
Waynesfield, OH 45896
Phone (419) 568-2225

Organizations & group practices 3

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": "1226361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280880000000",
    "number": "1063666519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "529 N WESTMINSTER ST",
            "city": "WAYNESFIELD",
            "state": "OH",
            "postal_code": "458969449",
            "telephone_number": "419-568-2225",
            "fax_number": "419-568-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "529 N WESTMINSTER ST",
            "address_2": "SUITE B",
            "city": "WAYNESFIELD",
            "state": "OH",
            "postal_code": "458969449",
            "telephone_number": "419-568-2225",
            "fax_number": "419-568-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "KARA",
        "middle_name": "SUZANNE",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-11-11",
        "last_updated": "2010-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038.011139",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "4028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waynesfield, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2010; 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.