Individual provider Active NPI

Brian Kenneth Neidenthal, D.C.

  • Chiropractor
  • Dublin, OH
National Provider Identifier
1124167101
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3219 Issued in OH
Practice address
5151 Post Rd
Suite 150
Dublin, OH 43017-1245
Phone
(614) 798-9600
Fax
(614) 798-0021
NPI assigned
Feb 6, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3219 OH Primary

Addresses

Primary practice location

5151 Post Rd
Suite 150
Dublin, OH 43017-1245

Mailing address

500 Carriage Dr
Plain City, OH 43064-2109
Phone (614) 560-0661

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081110000119 OH Practitioner - Chiropractic 8527127349 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2323 W 5TH Ave
Suite 110
Columbus, OH 43204-4899
Phone (614) 487-1905

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3219OHMDChiropractor

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124167101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 CARRIAGE DR",
            "city": "PLAIN CITY",
            "state": "OH",
            "postal_code": "430642109",
            "telephone_number": "614-560-0661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5151 POST RD",
            "address_2": "SUITE 150",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430171245",
            "telephone_number": "614-798-9600",
            "fax_number": "614-798-0021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEIDENTHAL",
        "first_name": "BRIAN",
        "middle_name": "KENNETH",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "3219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dublin, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.