Organization Active NPI

McClelland Chiropractic LLC

  • Chiropractor
  • Mount Gilead, OH
National Provider Identifier
1083897607
Registry record updated Jul 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3391 Issued in OH
Legal business name
MCCLELLAND CHIROPRACTIC LLC
Practice address
644 West Marion Rd
Mount Gilead, OH 43338-1056
Phone
(419) 946-5921
Fax
(419) 946-5665
NPI assigned
Dec 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2011

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

Authorized official

Name
Rebecca Lynn McClelland
Title
Office Manager
Phone
(419) 946-5921

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 3391 OH Primary

Addresses

Primary practice location

644 West Marion Rd
Mount Gilead, OH 43338-1056

Mailing address

644 West Marion Rd
Mount Gilead, OH 43338-1056
Phone (419) 946-5921

Other identifiers 1

IdentifierTypeStateIssuer
2384825MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080702000659 OH Part B Supplier - Clinic/Group Practice 2062584238 Receives reassigned benefits from 1 practitioner
Practice locations: Mount Gilead, OH

National Provider Directory

National Provider Directory

Locations

644 W Marion Rd
Mount Gilead, OH 43338
Phone (419) 946-5921

Practitioners & affiliated clinicians

Practitioners 1

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": "1196899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1309996800000",
    "number": "1083897607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "644 WEST MARION RD",
            "city": "MOUNT GILEAD",
            "state": "OH",
            "postal_code": "433381056",
            "telephone_number": "419-946-5921",
            "fax_number": "419-946-5665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "644 WEST MARION RD",
            "city": "MOUNT GILEAD",
            "state": "OH",
            "postal_code": "433381056",
            "telephone_number": "419-946-5921",
            "fax_number": "419-946-5665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCCLELLAND CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-06",
        "last_updated": "2011-07-07",
        "status": "A",
        "authorized_official_last_name": "MCCLELLAND",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "419-946-5921"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "3391",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2384825",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Gilead, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 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.