Individual provider Active NPI

Raymond F Harrison III, DC

  • Chiropractor
  • Medina, OH
National Provider Identifier
1184307027
Registry record updated Sep 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC-05261 Issued in OH
Practice address
780 East Smith Road
Suite a
Medina, OH 44256
Phone
(330) 725-4060
NPI assigned
Aug 8, 2023
Last updated
Sep 18, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC-05261 OH Primary

Addresses

Primary practice location

780 East Smith Road
Suite a
Medina, OH 44256

Mailing address

780 E Smith Rd
Medina, OH 44256-2662
Phone (218) 431-1090

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC-05261OHMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Mark J Stubbendieck DC Inc Chiropractor CurrentSince Sep 24, 2023 Accepting new patients

Locations

780 E Smith Rd
#A
Medina, OH 44256
Phone (330) 725-4060

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1691452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694995200000",
    "number": "1184307027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "780 E SMITH RD",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442562662",
            "telephone_number": "218-431-1090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "780 EAST SMITH ROAD",
            "address_2": "SUITE A",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "44256",
            "telephone_number": "330-725-4060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRISON",
        "first_name": "RAYMOND",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-08",
        "last_updated": "2023-09-18",
        "certification_date": "2023-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "DC-05261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medina, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.