Individual provider Active NPI

Shane Aaron Klingler, DC

  • Chiropractor
  • Defiance, OH
National Provider Identifier
1184733719
Registry record updated Oct 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC-02547 Issued in OH
Practice address
1770 Jefferson Ave
Defiance, OH 43512
Phone
(419) 782-2250
Fax
(419) 784-2347
NPI assigned
Aug 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X ACUP-00196 OH
Chiropractor 111N00000X DC-02547 OH Primary

Addresses

Primary practice location

1770 Jefferson Ave
Defiance, OH 43512

Mailing address

1770 Jefferson Ave
Defiance, OH 43512
Phone (419) 782-2250

Other identifiers 2

IdentifierTypeStateIssuer
2030555MedicaidOH
000000119617OtherANTHEM

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110210000033 OH Practitioner - Chiropractic 4981883683 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Defiance Chiropractic Center IncGroup PAC ID 4284813981, 6 clinicians

Practice addresses (Care Compare)

1770 Jefferson Ave
Defiance, OH 43512-3479
Phone (419) 784-2300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2547OHMDAddiction (Substance Use Disorder) Psychologist
DC-02547OHMDChiropractor
ACUP-00196OHMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Defiance Chiropractic Center, Inc. Chiropractor CurrentSince Jan 1, 1997 Accepting new patients

Locations

1770 Jefferson Ave
Defiance, OH 43512
Phone (419) 782-2250

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": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729468800000",
    "number": "1184733719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1770 JEFFERSON AVE",
            "city": "DEFIANCE",
            "state": "OH",
            "postal_code": "43512",
            "telephone_number": "419-782-2250",
            "fax_number": "419-784-2347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1770 JEFFERSON AVE",
            "city": "DEFIANCE",
            "state": "OH",
            "postal_code": "43512",
            "telephone_number": "419-782-2250",
            "fax_number": "419-784-2347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLINGLER",
        "first_name": "SHANE",
        "middle_name": "AARON",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2024-10-21",
        "certification_date": "2024-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "OH",
            "license": "ACUP-00196",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "DC-02547",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2030555",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000119617",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Defiance, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2024; 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.