NPIMap

Organization Active NPI

East Side Chiropractic Injury Treatment Center, LLC

  • Chiropractor
  • Dayton, OH
National Provider Identifier
1205963501
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2923 Issued in OH
Legal business name
EAST SIDE CHIROPRACTIC INJURY TREATMENT CENTER, LLC
Practice address
4325 Airway Rd
Dayton, OH 45431-1327
Phone
(937) 256-4951
Fax
(937) 256-5268
NPI assigned
Feb 27, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Kevin D Lehane, DCNPI 1114088655
Title
Owner
Phone
(937) 256-4951

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2923 OH Primary

Addresses

Primary practice location

4325 Airway Rd
Dayton, OH 45431-1327

Mailing address

4325 Airway Rd
Dayton, OH 45431-1327
Phone (937) 256-4951

Other identifiers 1

IdentifierTypeStateIssuer
2179477MedicaidOH

National Provider Directory

National Provider Directory

Locations

4325 Airway Rd
Dayton, OH 45431
Phone (937) 256-4951

Practitioners & affiliated clinicians

Practitioners 3

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": "1172534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1205963501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4325 AIRWAY RD",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454311327",
            "telephone_number": "937-256-4951",
            "fax_number": "937-256-5268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4325 AIRWAY RD",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454311327",
            "telephone_number": "937-256-4951",
            "fax_number": "937-256-5268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST SIDE CHIROPRACTIC INJURY TREATMENT CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LEHANE",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "937-256-4951",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "2923",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2179477",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.