Organization Active NPI

Buckeye Chiropractic Clinic Inc

  • Chiropractor
  • Willoughby, OH
National Provider Identifier
1083799654
Registry record updated Sep 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3454 Issued in OH
Legal business name
BUCKEYE CHIROPRACTIC CLINIC INC
Practice address
37131 Euclid Ave
Willoughby, OH 44094-5611
Phone
(440) 951-7246
Fax
(440) 946-3066
NPI assigned
Oct 25, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2011

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

Authorized official

Name
Dr. Christopher James Stankus, D.C.NPI 1457527905
Title
President
Phone
(440) 951-7246

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 3454 OH Primary

Addresses

Primary practice location

37131 Euclid Ave
Willoughby, OH 44094-5611

Mailing address

37131 Euclid Ave
Willoughby, OH 44094-5611
Phone (440) 951-7246

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060427000768 OH Part B Supplier - Clinic/Group Practice 0143230649 Receives reassigned benefits from 2 practitioners
Practice locations: Willoughby, OH

National Provider Directory

National Provider Directory

Locations

35104 Euclid Ave
Ste 208
Willoughby, OH 44094
Phone (440) 951-7246

37131 Euclid Ave
Willoughby, OH 44094
Phone (440) 946-8809

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314921600000",
    "number": "1083799654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37131 EUCLID AVE",
            "city": "WILLOUGHBY",
            "state": "OH",
            "postal_code": "440945611",
            "telephone_number": "440-951-7246",
            "fax_number": "440-946-3066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37131 EUCLID AVE",
            "city": "WILLOUGHBY",
            "state": "OH",
            "postal_code": "440945611",
            "telephone_number": "440-951-7246",
            "fax_number": "440-946-3066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BUCKEYE CHIROPRACTIC CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "last_updated": "2011-09-02",
        "status": "A",
        "authorized_official_last_name": "STANKUS",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "440-951-7246",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "3454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willoughby, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.