Cory Lamar, LLC

Primary specialty

Rehabilitation ChiropractorTaxonomy code 111NR0400X

Legal business name

CORY LAMAR, LLC

Doing business as

HealthSource of Rocky River

Practice address

21820 Center Ridge Rd
Rocky River, OH 44116-3921

Phone

(440) 308-7592

NPI assigned

Oct 11, 2018

Organization subpart

No

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

Authorized official

Name

Cory Randall LamarNPI 1902319148

Title

Owner

Phone

(440) 308-7592

Specialties & licenses 1

Addresses

Other names 1

• HealthSource of Rocky River Doing business as

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Locations

Practitioners 1

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

• Cory Randall Lamar, DC

  • Chiropractor
  • Rocky River, OH
  • NPI 1902319148
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1539216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1543795200000",
    "number": "1104391515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21820 CENTER RIDGE RD",
            "city": "ROCKY RIVER",
            "state": "OH",
            "postal_code": "441163921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21820 CENTER RIDGE RD",
            "city": "ROCKY RIVER",
            "state": "OH",
            "postal_code": "441163921",
            "telephone_number": "440-308-7592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORY LAMAR, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-11",
        "last_updated": "2018-12-03",
        "status": "A",
        "authorized_official_last_name": "LAMAR",
        "authorized_official_first_name": "CORY",
        "authorized_official_middle_name": "RANDALL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "440-308-7592"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HealthSource of Rocky River",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Rehabilitation Chiropractor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2018; 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.