Individual provider Active NPI

Carl Richard Dollison, D.C.

  • Chiropractor
  • Cambridge, OH
National Provider Identifier
1134119092
Registry record updated Dec 31, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1731 Issued in OH
Practice address
500 S 9TH St
Cambridge, OH 43725-2854
Phone
(740) 439-9393
Fax
(740) 439-9395
NPI assigned
Oct 24, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 31, 2014

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1731 OH Primary
Neurology Chiropractor 111NN0400X 1731 OH
Radiology Chiropractor 111NR0200X 1731 OH
Orthopedic Chiropractor 111NX0800X 1731 OH

Addresses

Primary practice location

500 S 9TH St
Cambridge, OH 43725-2854

Mailing address

500 S 9TH St
Cambridge, OH 43725-2854
Phone (740) 439-9393

Other identifiers 2

IdentifierTypeStateIssuer
0975388MedicaidOH
311410997-00OtherOHOHIO BWC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040730000990 OH Practitioner - Chiropractic 3274503693 Practice locations: Cambridge, OH

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

500 S 9TH St
Cambridge, OH 43725-2854
Phone (740) 439-9393

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1731OHMDOrthopedic Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Dollison Chiropractic Office, LTD Chiropractor PastSince Sep 1, 1994 Accepting new patients

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": "1130112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419984000000",
    "number": "1134119092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 S 9TH ST",
            "city": "CAMBRIDGE",
            "state": "OH",
            "postal_code": "437252854",
            "telephone_number": "740-439-9393",
            "fax_number": "740-439-9395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 S 9TH ST",
            "city": "CAMBRIDGE",
            "state": "OH",
            "postal_code": "437252854",
            "telephone_number": "740-439-9393",
            "fax_number": "740-439-9395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOLLISON",
        "first_name": "CARL",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-24",
        "last_updated": "2014-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "1731",
            "primary": true
        },
        {
            "code": "111NN0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Neurology",
            "state": "OH",
            "license": "1731",
            "primary": false
        },
        {
            "code": "111NR0200X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Radiology",
            "state": "OH",
            "license": "1731",
            "primary": false
        },
        {
            "code": "111NX0800X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Orthopedic",
            "state": "OH",
            "license": "1731",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0975388",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OHIO BWC",
            "identifier": "311410997-00",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambridge, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2014; 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.