Active NPI
Wayne D Lawrence, DC
- Sports Physician Chiropractor
- Coraopolis, PA
National Provider Identifier
1083273957
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Physician Chiropractor
- License
- DC011427
- Practice address
- 1635 Brodhead Rd
Coraopolis, PA 15108-3842 - Phone
- (724) 910-3235
- NPI assigned
- Jun 13, 2019
- Last updated
- Dec 23, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 12
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | DC011427 | PA | |
| Internist Chiropractor | 111NI0900X | DC011427 | PA | |
| Neurology Chiropractor | 111NN0400X | DC011427 | PA | |
| Nutrition Chiropractor | 111NN1001X | DC011427 | PA | |
| Radiology Chiropractor | 111NR0200X | DC011427 | PA | |
| Sports Physician Chiropractor | 111NS0005X | DC011427 | PA | Primary |
| Thermography Chiropractor | 111NT0100X | DC011427 | PA | |
| Occupational Health Chiropractor | 111NX0100X | DC011427 | PA | |
| Orthopedic Chiropractor | 111NX0800X | DC011427 | PA | |
| Pediatric Chiropractor | 111NP0017X | DC011427 | PA | |
| Rehabilitation Chiropractor | 111NR0400X | DC011427 | PA | |
| Independent Medical Examiner Chiropractor | 111NI0013X | DC011427 | PA |
Addresses
Primary practice location
1635 Brodhead Rd
Coraopolis, PA 15108-3842
Mailing address
1635 Brodhead Rd
Coraopolis, PA 15108-3842
Phone (724) 910-3235
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Other, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1635 Brodhead Rd
Coraopolis, PA 15108-3842
Phone (724) 457-1900
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DC011427 | PA | MD | Internist Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bon Meade Chiropractic Center, LLC | Chiropractor | Current | Accepting new patients |
Locations
1635 Brodhead Rd
Moon Twp, PA 15108
Phone (724) 457-1900
Organizations & group practices 1
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.
-
- Chiropractor
- Coraopolis, PA
- NPI 1265087225
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1560384000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1577059200000",
"number": "1083273957",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1635 BRODHEAD RD",
"city": "CORAOPOLIS",
"state": "PA",
"postal_code": "151083842",
"telephone_number": "724-910-3235"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1635 BRODHEAD RD",
"city": "CORAOPOLIS",
"state": "PA",
"postal_code": "151083842",
"telephone_number": "724-910-3235"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAWRENCE",
"first_name": "WAYNE",
"middle_name": "D",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-06-13",
"last_updated": "2019-12-23",
"certification_date": "2019-12-23",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "PA",
"license": "DC011427",
"primary": false
},
{
"code": "111NI0900X",
"taxonomy_group": "",
"desc": "Chiropractor, Internist",
"state": "PA",
"license": "DC011427",
"primary": false
},
{
"code": "111NN0400X",
"taxonomy_group": "",
"desc": "Chiropractor, Neurology",
"state": "PA",
"license": "DC011427",
"primary": false
},
{
"code": "111NN1001X",
"taxonomy_group": "",
"desc": "Chiropractor, Nutrition",
"state": "PA",
"license": "DC011427",
"primary": false
},
{
"code": "111NR0200X",
"taxonomy_group": "",
"desc": "Chiropractor, Radiology",
"state": "PA",
"license": "DC011427",
"primary": false
},
{
"code": "111NS0005X",
"taxonomy_group": "",
"desc": "Chiropractor, Sports Physician",
"state": "PA",
"license": "DC011427",
"primary": true
},
{
"code": "111NT0100X",
"taxonomy_group": "",
"desc": "Chiropractor, Thermography",
"state": "PA",
"license": "DC011427",
"primary": false
},
{
"code": "111NX0100X",
"taxonomy_group": "",
"desc": "Chiropractor, Occupational Health",
"state": "PA",
"license": "DC011427",
"primary": false
},
{
"code": "111NX0800X",
"taxonomy_group": "",
"desc": "Chiropractor, Orthopedic",
"state": "PA",
"license": "DC011427",
"primary": false
},
{
"code": "111NP0017X",
"taxonomy_group": "",
"desc": "Chiropractor, Pediatric Chiropractor",
"state": "PA",
"license": "DC011427",
"primary": false
},
{
"code": "111NR0400X",
"taxonomy_group": "",
"desc": "Chiropractor, Rehabilitation",
"state": "PA",
"license": "DC011427",
"primary": false
},
{
"code": "111NI0013X",
"taxonomy_group": "",
"desc": "Chiropractor, Independent Medical Examiner",
"state": "PA",
"license": "DC011427",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Coraopolis, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2019; 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.