Active NPI
Tynan Mathew Flegg, DC
- Chiropractor
- Lebanon, OH
National Provider Identifier
1205540630
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- DC05206
- Practice address
- 920 Columbus Ave
Lebanon, OH 45036-1402 - Phone
- (563) 396-9539
- NPI assigned
- Jan 10, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | DC05206 | OH | Primary |
Addresses
Primary practice location
920 Columbus Ave
Lebanon, OH 45036-1402
Mailing address
920 Columbus Ave
Lebanon, OH 45036-1402
Phone (563) 396-9539
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DC05206 | OH | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1673308800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1673308800000",
"number": "1205540630",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "920 COLUMBUS AVE",
"city": "LEBANON",
"state": "OH",
"postal_code": "450361402",
"telephone_number": "563-396-9539"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "920 COLUMBUS AVE",
"city": "LEBANON",
"state": "OH",
"postal_code": "450361402",
"telephone_number": "563-396-9539"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FLEGG",
"first_name": "TYNAN",
"middle_name": "MATHEW",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-01-10",
"last_updated": "2023-01-10",
"certification_date": "2022-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "OH",
"license": "DC05206",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lebanon, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 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.