Individual provider Active NPI

Rebecca L Fabry, D.C.

  • Chiropractor
  • Saint Clairsville, OH
National Provider Identifier
1104136589
Registry record updated Oct 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4053 Issued in OH
Practice address
161 S Sugar St
Saint Clairsville, OH 43950-1636
Phone
(740) 695-3004
Fax
(740) 695-3009
NPI assigned
Oct 19, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 19, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4053 OH Primary
Chiropractor 111N00000X 915 WV

Addresses

Primary practice location

161 S Sugar St
Saint Clairsville, OH 43950-1636

Mailing address

161 S Sugar St
Saint Clairsville, OH 43950-1636
Phone (740) 695-3004

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110209000557 OH Practitioner - Chiropractic 0547440497 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

161 S Sugar St
Saint Clairsville, OH 43950-1636
Phone (740) 695-3004

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
St Clairsville Chiropractic Clinic LLC Chiropractor CurrentSince Dec 30, 2010 Accepting new patients
Jobeth Rollandini, DPM, LLC PastSince Dec 30, 2010 Accepting new patients

Locations

161 S Sugar St
St Clairsvle, OH 43950
Phone (740) 695-3004

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1287446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287446400000",
    "number": "1104136589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "161 S SUGAR ST",
            "city": "SAINT CLAIRSVILLE",
            "state": "OH",
            "postal_code": "439501636",
            "telephone_number": "740-695-3004",
            "fax_number": "740-695-3009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 S SUGAR ST",
            "city": "SAINT CLAIRSVILLE",
            "state": "OH",
            "postal_code": "439501636",
            "telephone_number": "740-695-3004",
            "fax_number": "740-695-3009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FABRY",
        "first_name": "REBECCA",
        "middle_name": "L",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-19",
        "last_updated": "2010-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "4053",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WV",
            "license": "915",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Clairsville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2010; 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.