Individual provider Active NPI

Nathaniel Betts, DC

  • Chiropractor
  • North Canton, OH
National Provider Identifier
1215557764
Registry record updated Mar 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC-04969 Issued in OH
Practice address
3313 Lee St NW
North Canton, OH 44720-4735
Phone
(330) 818-2196
Fax
(330) 818-2199
NPI assigned
Apr 24, 2020
Last updated
Mar 2, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2021

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-04969 OH Primary

Addresses

Primary practice location

3313 Lee St NW
North Canton, OH 44720-4735

Mailing address

3313 Lee St NW
North Canton, OH 44720-4735
Phone (330) 818-2196

Other identifiers 2

IdentifierTypeStateIssuer
NAOtherCHIROPRACTIC
DC-04969OtherOHLICENSE NUMBER

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL fergusonfcwc@gmail.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210312000166 OH Practitioner - Chiropractic 4587070719 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Peak Family Chiropractic LLCGroup PAC ID 9032361563, 5 clinicians

Practice addresses (Care Compare)

132 Merz Blvd
Fairlawn, OH 44333-2816
Phone (330) 670-9400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC-04969OHMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Peak Family Chiropractic LLC Chiropractor CurrentSince Jul 31, 2023 Accepting new patients
Fairlawn Foot & Ankle Clinic Inc PastSince Jul 31, 2023 Accepting new patients

Locations

132 Merz Blvd
Fairlawn, OH 44333
Phone (330) 670-9400

Organizations & group practices 2

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": "1587686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614643200000",
    "number": "1215557764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3313 LEE ST NW",
            "city": "NORTH CANTON",
            "state": "OH",
            "postal_code": "447204735",
            "telephone_number": "330-818-2196",
            "fax_number": "330-818-2199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3313 LEE ST NW",
            "city": "NORTH CANTON",
            "state": "OH",
            "postal_code": "447204735",
            "telephone_number": "330-818-2196",
            "fax_number": "330-818-2199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BETTS",
        "first_name": "NATHANIEL",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-24",
        "last_updated": "2021-03-02",
        "certification_date": "2021-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "DC-04969",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHIROPRACTIC",
            "identifier": "NA",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "DC-04969",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "fergusonfcwc@gmail.com",
            "affiliation": "N",
            "address_1": "3313 Lee St NW",
            "city": "North Canton",
            "state": "OH",
            "country_code": "US",
            "postal_code": "447204735",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in North Canton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2021; 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.