Organization Active NPI

Holmes Spine & Sport Chiropractic Clinic Inc.

  • Chiropractor
  • Millersburg, OH
National Provider Identifier
1184738296
Registry record updated Mar 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
HOLMES SPINE & SPORT CHIROPRACTIC CLINIC INC.
Practice address
1245 Glen Dr
Millersburg, OH 44654-8958
Phone
(330) 674-0444
Fax
(330) 674-0802
NPI assigned
Aug 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2012

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

Authorized official

Name
Mr. Rex A Smetzer
Title
Office Manager
Phone
(330) 674-0444

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

1245 Glen Dr
Millersburg, OH 44654-8958

Mailing address

1245 Glen Dr
Millersburg, OH 44654-8958
Phone (330) 674-0444

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040719000136 OH Part B Supplier - Clinic/Group Practice 4587643085 Receives reassigned benefits from 2 practitioners
Practice locations: Millersburg, OH

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
36D2023012Holmes Spine & Sport Chiropractic Clinic1245 Glen Drive, Millersburg, OH 44654Certificate of waiverApr 13, 2027

National Provider Directory

National Provider Directory

Locations

1245 Glen Dr
Millersburg, OH 44654
Phone (330) 674-0196

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332979200000",
    "number": "1184738296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1245 GLEN DR",
            "city": "MILLERSBURG",
            "state": "OH",
            "postal_code": "446548958",
            "telephone_number": "330-674-0444",
            "fax_number": "330-674-0802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1245 GLEN DR",
            "city": "MILLERSBURG",
            "state": "OH",
            "postal_code": "446548958",
            "telephone_number": "330-674-0444",
            "fax_number": "330-674-0802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLMES SPINE & SPORT CHIROPRACTIC CLINIC INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-18",
        "last_updated": "2012-03-29",
        "status": "A",
        "authorized_official_last_name": "SMETZER",
        "authorized_official_first_name": "REX",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "330-674-0444",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Millersburg, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2012; 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.