Individual provider Active NPI

Maureen L Passifiume, DC

  • Chiropractor
  • Worthington, OH
National Provider Identifier
1073513842
Registry record updated Apr 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
U83062 Issued in OH
Practice address
5577 N High St
Worthington, OH 43085-3914
Phone
(614) 436-3870
Fax
(614) 436-0953
NPI assigned
Jul 22, 2005
Last updated
Apr 2, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X U83062 OH Primary

Addresses

Primary practice location

5577 N High St
Worthington, OH 43085-3914

Mailing address

5577 N High St
Worthington, OH 43085-3914
Phone (614) 436-3870

Other identifiers 2

IdentifierTypeStateIssuer
4038961OtherOHMEDICARE-INDIVIDUAL
PA2205563MedicaidOH

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
U83062OHMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1121990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207094400000",
    "number": "1073513842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5577 N HIGH ST",
            "city": "WORTHINGTON",
            "state": "OH",
            "postal_code": "430853914",
            "telephone_number": "614-436-3870",
            "fax_number": "614-436-0953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5577 N HIGH ST",
            "city": "WORTHINGTON",
            "state": "OH",
            "postal_code": "430853914",
            "telephone_number": "614-436-3870",
            "fax_number": "614-436-0953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PASSIFIUME",
        "first_name": "MAUREEN",
        "middle_name": "L",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-22",
        "last_updated": "2008-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "U83062",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE-INDIVIDUAL",
            "identifier": "4038961",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PA2205563",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Worthington, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2008; 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.