Individual provider Active NPI

Wayne D Lawrence, DC

  • Sports Physician Chiropractor
  • Coraopolis, PA
National Provider Identifier
1083273957
Registry record updated Dec 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
License
DC011427 Issued in PA
Practice address
1635 Brodhead Rd
Coraopolis, PA 15108-3842
Phone
(724) 910-3235
NPI assigned
Jun 13, 2019
Last updated
Dec 23, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 23, 2019

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

Specialties & licenses 12

Specialty (taxonomy)CodeLicenseStatePrimary
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

Enrollment IDStateProvider typePAC IDDetails
I20200122000298 PA Practitioner - Chiropractic 0345675328 Reassigns benefits to 1 organization

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

LicenseStateTypeSpecialty
DC011427PAMDInternist Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Bon Meade Chiropractic Center, LLC Chiropractor CurrentSince Jan 6, 2020 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.

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.

Verify at the official NPI Registry.